Inactivated by formalin and adsorbed onto aluminum salts to enhance immunogenicity.
Single dose contains 5 limit of flocculation (Lf) of toxoid.
Confers active immunity and generates immune memory requiring periodic boosters.
Administered via intramuscular route, preferring anterolateral thigh for infants and deltoid for older children.
Available widely in combinations like diphtheria, tetanus, whole-cell pertussis (DTwP), diphtheria, tetanus, acellular pertussis (DTaP), tetanus and reduced diphtheria (Td), and pentavalent vaccines.
Immunization Schedule
Routine Childhood And Adolescent Immunization
Age Group
Recommended Schedule
Preferred Formulation
Infants
6, 10, and 14 weeks
Pentavalent or hexavalent combinations
Toddlers
15-18 months (first booster)
DTwP or DTaP combinations
Children
4-6 years (second booster)
DTwP or DTaP combinations
Adolescents
10-12 years
Tdap
Adults
Every 10 years
Td or Tdap
Maternal Immunization
Routine immunization during pregnancy declines neonatal tetanus incidence.
Provides passive immunity to newborn via transplacental passage of immunoglobulin G (IgG) antibodies.
Recommend single dose of Tdap during each pregnancy, preferably between 27 and 36 weeks.
Unimmunized pregnant women require two doses, including one Tdap, administered at least 1 month apart, with second dose at least 2 weeks before delivery.
Wound Management Prophylaxis
Tetanus toxoid and tetanus immunoglobulin (TIG) indications depend on wound severity and previous vaccination status.
Previous Vaccine Doses
Clean Minor Wound
All Other Wounds
Unknown or <3 doses
Vaccine yes, TIG no
Vaccine yes, TIG yes
>=3 doses, <5 years ago
Vaccine no, TIG no
Vaccine no, TIG no
>=3 doses, 5-10 years ago
Vaccine no, TIG no
Vaccine yes, TIG no
>=3 doses, >10 years ago
Vaccine yes, TIG no
Vaccine yes, TIG no
Administer Tdap or Td for children >7 years needing wound prophylaxis.
Provide catch-up vaccination with three doses at 0, 1, and 6 months for completely unimmunized individuals.
Efficacy And Storage
Protective Efficacy
Vaccine efficacy varies between 80% and 100%.
Protective antitoxin level defined as 0.01 IU/mL.
Protection level depends on toxin load during exposure.
Storage Conditions
Heat stable vaccine, remains potent for few weeks even at 37°C.
Ideal storage temperature maintained strictly at 2-8°C.
Freezing strictly contraindicated; accidentally frozen vaccine must be discarded immediately.
Adverse Effects And Contraindications
Common minor reactions include local pain, swelling, and redness at injection site.
Systemic effects like fever and headache observed infrequently.
Absolute contraindication includes severe allergic reaction or anaphylaxis following prior dose.
