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ANTIINFECTIVES FOR SYSTEMIC USE › VACCINES › BACTERIAL VACCINES › Tetanus vaccines
tetanus toxoid, combinations with tetanus immunoglobulin
J07AM52
Forms & Strengths
- Combined tetanus toxoid and tetanus immune globulin products are not standard commercial combination formulations; they are typically administered as separate components (tetanus toxoid vaccine and Tetanus Immune Globulin [TIG]) for simultaneous post-exposure prophylaxis.
Adult Dosing
- Post-exposure prophylaxis: 250 units to 500 units of TIG administered intramuscularly (IM) in a separate site from the tetanus toxoid vaccine (0.5 mL IM).
- Administer tetanus toxoid-containing vaccine (e.g., Tdap or Td) concurrently for wound management if the patient's vaccination history is incomplete, unknown, or if they have received fewer than 3 previous doses.
Pediatric Dosing
- Post-exposure prophylaxis (Children < 7 years): DTaP is preferred for vaccination; TIG dosage is 250 units IM.
- Post-exposure prophylaxis (Children ≥ 7 years): Tdap or Td preferred for vaccination; TIG dosage is 250 units to 500 units IM administered concurrently at a separate site.
Indications
- Post-exposure prophylaxis of tetanus in individuals with tetanus-prone wounds (e.g., contaminated with dirt, feces, soil, saliva; puncture wounds; crush wounds; avulsions; wounds resulting from thermal or freezing trauma) and unknown or incomplete (fewer than 3 doses) primary tetanus vaccination history.
Mechanism of Action
- Tetanus toxoid: Induces active immunity by stimulating the production of neutralizing antibodies against the neurotoxin produced by Clostridium tetani.
- Tetanus Immune Globulin (TIG): Provides immediate passive immunity by supplying human monoclonal or polyclonal antibodies (IgG) that neutralize circulating or unbound tetanus toxin.
Contraindications
- History of severe allergic reaction (e.g., anaphylaxis) to a previous dose of tetanus toxoid-containing vaccine or any component of the TIG product.
- Moderate or severe acute illness with or without fever (defer vaccination until illness resolves).
Adverse Reactions
- Injection site reactions: Pain, erythema, swelling, and induration.
- Systemic reactions: Low-grade fever, malaise, headache, myalgia, and fatigue.
- Rare: Anaphylaxis, hypersensitivity reactions, Arthus-type hypersensitivity reactions.
Drug Interactions
- Immunosuppressive therapies (including high-dose corticosteroids, antimetabolites, alkylating agents, radiation): May reduce the immune response to the tetanus toxoid vaccine.
- Other live or inactivated vaccines: Can be administered concomitantly at different injection sites using separate syringes.
Curated Content: Needs Vetting Before Put to Clinical Use