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Tetanus & Diphtheria Vaccine

Facts about Td: Td is for use among persons 7 years of age and older. For primary vaccination, a series of three doses of Td should be administered intramuscularly; the second dose is given 4-8 weeks after the first, and the third dose 6-12 months after the second. Interrupting the recommended schedule or delaying subsequent doses does not lead to a reduction in the level of immunity reached on completion of the primary series. Therefore, there is no need to restart a series if more than the recommended time between doses has elapsed. Td boosters should be given every 10 years; if a dose is given sooner as part of wound management, the next booster is not needed until 10 years thereafter.

Health-care providers using Td for wound management should follow recommendations from the Advisory Committee on Immunization Practices for wound management. All wound patients should receive Td if they have received <3 tetanus-containing vaccines or if vaccination history is uncertain. These patients also should receive tetanus immune globulin for wounds that are contaminated with dirt, feces, soil or saliva, puncture wounds, and avulsions and wounds resulting from missiles, crushing, burns or frostbite. For persons with >3 doses of tetanus toxoid-containing vaccine and severe or contaminated wounds, Td should be given only if >5 years have passed since the last dose of tetanus-containing vaccine. For clean and minor wounds, Td should be given only if the patient has not received a tetanus-containing vaccine during the preceding 10 years. Health-care providers should inquire from patients presenting for wound management about the timing of their last tetanus-containing vaccine to avoid unnecessary vaccination.

In the event of a moderate or severe reaction, physicians should ascertain the date and time of the reaction as well as when the vaccination was administered. Physicians should contact the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967 or on the web.

Additional information is available from the CDC on Tetanus

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