Adsorbed tetanus vaccine

• Approved Indications:
• Active immunization against tetanus caused by Clostridium tetani.
• Prevention of tetanus in individuals at risk due to wounds or injuries that may be contaminated.
• Routine immunization in childhood and adults as per immunization schedules.
• Booster doses to maintain immunity every 10 years or after high-risk injury if last dose was >5 years ago.
• Important Off-label (Clinically Accepted) Uses:
• Combined use in diphtheria-tetanus (DT), tetanus-diphtheria-pertussis (Tdap), or diphtheria-tetanus-acellular pertussis (DTaP) vaccines for broader protection.
• Use in pregnant women to prevent neonatal tetanus (maternal immunization).

• Adults and Adolescents:
• Primary series or booster dose: 0.5 mL intramuscular (IM) injection.
• Booster recommended every 10 years for sustained immunity.
• For wound management: if primary series incomplete, administer immediately and consider TIG (tetanus immune globulin).
• Pediatrics:
• Given as part of DTaP series at 2, 4, 6, 15–18 months, and 4–6 years.
• Dose: 0.5 mL IM per age-appropriate schedule.
• Elderly:
• Same as adult dosing; booster every 10 years recommended.
• Special Populations:
• No dosage adjustment needed for renal or hepatic impairment.
• Administration Route:
• Intramuscular injection, preferably in the deltoid region of the arm.

The adsorbed tetanus vaccine contains inactivated tetanus toxoid, which is a chemically detoxified form of the tetanus toxin produced by Clostridium tetani. Upon intramuscular injection, the toxoid acts as an antigen, stimulating the immune system to produce specific antibodies against the tetanus toxin without causing disease. These antibodies provide active immunity by neutralizing the toxin if exposure occurs, preventing the development of tetanus symptoms.

• Absorption: Rapid local uptake at injection site.
• Distribution: Induces systemic immune response; no systemic distribution of the toxoid itself.
• Metabolism: Not applicable (vaccine antigen).
• Elimination: Immune system-mediated clearance of antigen.
• Onset of Immunity: Protective antibody levels generally develop within 10–14 days after vaccination.
• Duration: Immunity lasts approximately 10 years post-vaccination or booster.

• Pregnancy: Considered safe; no evidence of risk to the fetus. Vaccination is recommended during pregnancy (preferably 27–36 weeks gestation) to protect newborns from neonatal tetanus.
• Lactation: Safe during breastfeeding; no adverse effects reported.

• Vaccine
• Subclass: Tetanus toxoid vaccine (adsorbed)

• Known hypersensitivity to any component of the vaccine, including aluminum adjuvants.
• Severe allergic reaction (anaphylaxis) after previous dose.
• Moderate or severe acute illness (vaccination should be postponed).

• Use caution in individuals with a history of neurological disorders post-immunization.
• Observe for 15 minutes post-injection for possible anaphylactic reactions.
• Administer with caution in patients with bleeding disorders due to IM route.
• Avoid simultaneous administration with other vaccines in the same limb.
• Monitor injection site for severe local reactions.

• Common:
• Injection site pain, redness, swelling
• Mild fever
• Fatigue, headache, muscle aches
• Serious/Rare:
• Severe allergic reactions (anaphylaxis)
• Persistent neurological symptoms (extremely rare)
• Arthus reaction (localized vasculitis with pain and swelling)

• No significant drug interactions reported.
• May be administered concomitantly with other vaccines at separate injection sites without interference.
• Immunosuppressive therapy may reduce vaccine effectiveness.

• WHO and CDC recommend booster doses every 10 years for sustained immunity.
• Updated guidelines emphasize maternal immunization to prevent neonatal tetanus.
• No recent changes to vaccine composition or approved indications.
• Continued monitoring for vaccine safety and efficacy remains ongoing globally.

• Store refrigerated at 2°C to 8°C (36°F to 46°F).
• Do not freeze.
• Protect from light.
• Use within manufacturer’s expiration date.
• Shake well before use to ensure uniform suspension.