Diphtheria and tetanus toxoids vaccine

The diphtheria and tetanus toxoids vaccine is a combination vaccine used to prevent diphtheria and tetanus.

• Diphtheria and tetanus toxoids vaccines are available under various brand names: Diphtheria-Tetanus Toxoids, Pediatric (DT)

Common side effects of Diphtheria and tetanus toxoids vaccine include:

• redness, pain, tenderness, swelling, or a hard lump where the shot was given;
• mild fever;
• mild fussiness or crying;
• joint pain, body aches;
• mild drowsiness; or
• mild vomiting.

Serious side effects of Diphtheria and tetanus toxoids vaccine include:

• hives,
• difficult breathing,
• swelling of the face, lips, tongue, or throat.
• extreme drowsiness, fainting;
• severe headache or vomiting;
• fussiness, irritability, crying for an hour or longer;
• confusion, seizure (black-out or convulsions); or
• high fever.

Rare side effects of Diphtheria and tetanus toxoids vaccine include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

 Adult and pediatric dosage

Injection, suspension (Td)

• (2 Lf/2 Lf)/0.5 mL (TDVAX)
• (2 Lf/5 Lf)/0.5 mL (Tenivac)
• Booster immunization (Td [eg, TDVax, Tenivac]

Adult dosage

• IM: 0.5 mL every 10 years (for a routine booster in patients who have completed primary immunization series

Pediatric dosage

• Children above 11 years and Adolescents below 18 years: Td (e.g., TDVax, Tenivac): IM: 0.5 mL as a single dose; preferred age for a booster is 11 to 12 years of age. If not contraindicated, Tdap is the preferred agent for this dose. Booster doses of either Td or Tdap are recommended every 10 years thereafter

Primary immunization

Adult dosage

• IM: Patients previously not immunized should receive 2 primary doses of 0.5 mL each, given at an interval of at least 4 weeks; a third (reinforcing) dose of 0.5 mL 6 to 12 months later
• Pediatric dosage
• Pediatric formulation (DT): IM: 0.5 mL per dose for a total of 5 doses administered as follows:
• Three doses (primary series), usually given at 2-, 4-, and 6 months of age; may be given as early as 6 weeks of age and repeated every 4 to 8 weeks.
• Fourth dose (first booster): Given at approximately 15 to 18 months of age, but at least 6 months after the third dose. The fourth dose may be given as early as 12 months of age, but at least 6 months must have elapsed between the third dose and the fourth dose. The fourth dose does not need to be repeated if inadvertently administered at least 4 months after the third dose.
• Fifth dose (second booster): Given at 4 to 6 years of age, prior to starting school or kindergarten; if the fourth dose is given at above 4 years of age, the fifth dose may be omitted.
• Tetanus prophylaxis in wound management
• Adult dosage
• IM: Tetanus prophylaxis in patients with wounds should be based on if the wound is clean or contaminated and the immunization status of the patient, including the time from the last tetanus-containing vaccine.

Pediatric dosage

• Infants, Children, and Adolescents: Tetanus prophylaxis in patients with wounds should be based on if the wound is clean or contaminated, and the immunization status of the patient, including the time from the last tetanus-containing vaccine

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

• Diphtheria and tetanus toxoids vaccines have severe interactions with the following drug:
  • belimumab
• Diphtheria and tetanus toxoids vaccines have serious interactions with at least 37 other drugs.
• Diphtheria and tetanus toxoids vaccines have moderate interactions with the following drugs:
  • belatacept
  • certolizumab pegol
  • dengue vaccine
  • ifosfamide
  • melphalan
  • mercaptopurine
  • methotrexate
  • oxaliplatin
• Diphtheria and tetanus toxoids vaccines have minor interactions with the following drug:
  • chloroquine

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Your child should not receive this vaccine if the child has:
  • untreated or uncontrolled epilepsy or other seizure disorder; or
  • if the child has received cancer chemotherapy or radiation treatment in the past 3 months.
• Your child may not be able to receive this vaccine if he or she has ever received a similar vaccine that caused any of the following:
  • a very high fever (over 104 degrees);
  • a neurologic disorder or disease affecting the brain;
  • excessive crying for 3 hours or longer;
  • fainting or going into shock;
  • Guillain-Barré syndrome (within 6 weeks after receiving a vaccine);
  • seizure (convulsions); or
  • a severe skin reaction.
• If your child has any of these other conditions, this vaccine may need to be postponed or not given at all:
  • a bleeding or blood clotting disorder such as hemophilia or easy bruising;
  • a history of seizures;
  • a neurologic disorder or disease affecting the brain (or if this was a reaction to a previous vaccine);
  • an allergy to latex rubber;
  • a weak immune system caused by disease, bone marrow transplant, or using certain medicines or receiving cancer treatments; or
  • if the child is taking a blood thinner such as warfarin (Coumadin).

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Diphtheria and tetanus toxoids vaccine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Diphtheria and tetanus toxoids vaccine?”

Cautions

• Diphtheria and tetanus toxoids vaccine is given in a series of shots. The first shot is usually given when the child is 2 months old. The booster shots are then given at 4 months, 6 months, and 12 to 18 months of age. A fifth booster dose is given between 4 and 6 years of age.
• Your child's booster schedule may be different from these guidelines. Follow your doctor's instructions or the schedule recommended by your local health department.
• The pediatric version of this vaccine (DT) should not be given to anyone over the age of 6 years old. Another vaccine is available for use in older children and adults.
• Be sure your child receives all recommended doses of this vaccine. Your child may not be fully protected against disease if he or she does not receive the full series.
• Your child can still receive a vaccine if he or she has a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until the child gets better before receiving this vaccine.
• Your child should not receive a booster vaccine if he or she had a life-threatening allergic reaction after the first shot.
• Keep track of any and all side effects your child has after receiving this vaccine. When the child receives a booster dose, you will need to tell the doctor if the previous shot caused any side effects.
• Becoming infected with diphtheria or tetanus is much more dangerous to your child's health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.
• Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Pregnancy & Lactation

• There is insufficient human data to establish the presence or absence of a vaccine-associated risk.

Lactation

• Unknown if excreted in human milk