Adult Dosing
Active immunization for preventing tetanus
Primary immunization
- 0.5 mL IM x2 doses 4-8 wks apart, then 0.5 mL IM x1 dose 6-12 months after prior dose
Routine booster immunization in adults who have completed primary immunization against tetanus
- 0.5 mL IM x1 dose every 10 yrs
- If a dose of tetanus toxoid-containing vaccine is given earlier than 10 years (as part of wound management or on exposure to diphtheria), then the next booster dose is not required for 10 yrs thereafter
- Give a booster dose for tetanus-prone wounds if no tetanus toxoid-containing vaccine is received within the last 5 yrs
Notes:- Inspect visually for extraneous particulate matter and/or discoloration prior to administration; discard the vaccine if such conditions exist
- Shake vial well before withdrawing each dose; discard vial if vaccine cannot be resuspended
- Cleanse the skin over the site to be injected with a suitable germicide
- Inject IM in the area of the vastus lateralis (mid-thigh laterally) or deltoid; do not inject into the gluteal area or areas where there may be a major nerve trunk
Pediatric Dosing
- Not indicated for immunization of infants and children <7 yrs of age
Active immunization for preventing tetanus
Primary immunization (Children 
7 yrs)
- 0.5 mL IM x2 doses 4-8 wks apart, then 0.5 mL IM x1 dose 6-12 months after prior dose
Routine booster immunization in children 7 yrs who have completed primary immunization against tetanus
- 0.5 mL IM x1 in children 11-12 yrs if at least 5 yrs have elapsed since the last dose of a tetanus and diphtheria toxoid-containing vaccine
- Subsequent routine booster immunization is 0.5 mL IM x1 dose every 10yrs; Tdap vaccine preferred at 11-12 yrs, then Td preferred for subsequent booster doses
- If a dose of tetanus toxoid-containing vaccine is given earlier than 10 years (as part of wound management or on exposure to diphtheria), then the next booster dose is not required for 10 yrs thereafter
- Give a booster dose for tetanus-prone wounds if no tetanus toxoid-containing vaccine is received within the last 5 yrs
Notes:- May be used to complete the primary immunization series for tetanus in children 7 yrs who have received one or two doses of whole-cell pertussis DTP, DTaP, and/or DT vaccine (safety and efficacy of tetanus toxoid adsorbed in such children is not established)
- Inspect visually for extraneous particulate matter and/or discoloration prior to administration; discard the vaccine if such conditions exist
- Shake vial well before withdrawing each dose; discard vial if vaccine cannot be resuspended
- Cleanse the skin over the site to be injected with a suitable germicide
- Inject IM in the area of the vastus lateralis (mid-thigh laterally) or deltoid; do not inject into the gluteal area or areas where there may be a major nerve trunk
[Outline]
See Supplemental Patient Information
- The multi-dose vial stopper contains dry natural latex rubber, which may cause allergic reactions in latex-sensitive individuals
- Booster doses of tetanus toxoid adsorbed should not be administered more frequently than recommended (except in case of wound management) as it may be associated with increased incidence and severity of adverse reactions
- Individuals with hx of severe Arthus-type hypersensitivity reactions following a prior dose of tetanus toxoid usually have very high serum tetanus antitoxin levels. It is recommended not to give even emergency doses of tetanus toxoid adsorbed more frequently than q10 years in such cases, even if they have a wound that is neither clean nor minor
- Do not administer to persons with any bleeding disorder, such as hemophilia or thrombocytopenia, or to persons on anticoagulant therapy unless the potential benefits clearly outweigh the risk of administration. Exercise caution if the decision is made to administer therapy in such persons, with steps taken to avoid the risk of hematoma formation following injection
- Epinephrine injection (1:1000) and other appropriate agents and equipment should be available for immediate use in case an anaphylactic or acute hypersensitivity reaction occurs
- Prior to administration of tetanus toxoid adsorbed, review the vaccine recipient's personal health history and current health status including the patient’s immunization history, any adverse events after previous immunizations and history concerning possible sensitivity to the vaccine and to dry natural latex rubber to determine the possibility of any contraindications and to assess the benefits and risks of vaccination
- Exercise caution to ensure that the injection does not enter a blood vessel
- Immunocompromised individuals may not obtain the expected immune response to this vaccine
Cautions: Use cautiously in
- Hypersensitivity to latex
- Hx of tetanus toxoid-related Guillain-Barre syndrome
- Immunocompromised persons
Supplemental Patient Information
- Inform the vaccine recipients or their parents/guardians of the benefits and risks of immunization, prior to administration of tetanus toxoid adsorbed
- Inform the parent, guardian, or adult patient of the importance of completing the primary immunization series or receiving recommended booster doses, as appropriate
Pregnancy Category:C
Breastfeeding: It is unknown whether tetanus toxoid adsorbed is excreted in human milk. However, the manufacturer advises to use caution while administering it to a nursing woman.
US Trade Name(s)
US Availability
tetanus toxoid adsorbed (generic)
- INJ: 5 Lf units/0.5 mL (5 mL vial)
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
[Outline]