DIPHTHERIAAND TETANUS TOXOIDS (Systemic)

A commonly used name for diphtheria and tetanus toxoidsfor pediatric use is DT.

A commonly used name for tetanus and diphtheria toxoids for adult use is Td.

Category

• Immunizing agent, active

Description

Diphtheriaand Tetanus Toxoids (also known as DT and Td) is a combination immunizingagent given by injection to prevent diphtheria and tetanus.

Diphtheria is a serious illness that can cause breathing difficulties,heart problems, nerve damage, pneumonia, and possibly death. The risk of seriouscomplications and death is greatest in very young children and in the elderly.

Tetanus (also known as lockjaw) is a serious illness that causes convulsions(seizures) and severe muscle spasms that can be strong enough to cause bonefractures of the spine. Tetanus causes death in 30 to 40 percent of cases.

Immunization with diphtheria and tetanus toxoids for pediatric use (DT)is recommended for infants and children from 6 weeks of age (8 weeks in Canada)up until their 7th birthday.

Children 7 years of age and older and adults should be immunized with tetanusand diphtheria toxoids for adult use (Td). In addition, these children andadults should receive booster doses of Td every 10 years for the rest of theirlives.

Diphtheria and tetanus are serious diseases that can cause life-threateningillnesses. Although some serious side effects can occur after a dose of DTor Td, these are rare. The chance of your child catching one of these diseasesand being permanently injured or dying as a result is much greater than thechance of your child getting a serious side effect from the DT or Td vaccine.

DT and Td are available in the following dosage form:

Parenteral
• Injection (U.S. and Canada)

Before Receiving This Vaccine

In deciding to use a vaccine, the risks of using the vaccine must be weighedagainst the good it will do. This is a decision you and your doctor will make.For DT and Td, the following should be considered:

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to diphtheria toxoid, tetanus toxoid, DT, or Td. Also tellyour health care professional if you are allergic to any other substances,such as preservatives.

Pregnancy?This vaccine has not been shown to cause birth defectsor other problems in humans. Immunization of a pregnant woman can preventher newborn baby from getting tetanus at birth.

Breast-feeding?This vaccine has not been shown to cause problemsin nursing babies.

Children?For infants up to 6 weeks of age, use of DT or Tdis not recommended.

For infants and children 6 weeks up to 7 years of age, Td is not recommended.DT is used instead.

For children 7 years of age and older, DT is not recommended. Td is usedinstead.

Older adults?DT is not recommended. Td is used instead. Td isnot expected to cause different side effects or problems in older people thanit does in younger adults. However, Td may be slightly less effective in olderpeople than in younger adults.

Other medical problems?The presence of other medical problems may affectthe use of DT or Td. Make sure you tell your doctor if you have any othermedical problems, especially:

• Fever or
• Infection or illness (severe)?Use of DT or Td may make thecondition worse or may increase the chance of side effects

Proper Use of This Vaccine

Dosing?The doses of DT and Td will be different fordifferent patients. The following information includes only the average dosesof DT and Td.

For DT
• For injection dosage form:
  • For prevention of diphtheria and tetanus:
    • Children up to 6 weeks of age?Use is not recommended.
    • Children 6 weeks to 1 year of age?One dose is given every fourto eight weeks for a total of three doses. A fourth dose is given six to twelvemonths after the third dose. A booster (fifth) dose is given when the childis four to six years of age. The booster (fifth) dose is given only if thefourth dose was given before the child's fourth birthday. The doses are injectedinto a muscle.
    • Children 1 to 7 years of age?One dose is given at the firstvisit to the doctor, followed by a second dose four to eight weeks later.A third dose is given six to twelve months after the second dose. A booster(fourth) dose is given when the child is four to six years of age. The booster(fourth dose) is given only if the third dose was given before the child'sfourth birthday. The doses are injected into a muscle.
    • Adults and children 7 years of age and over?Use is not recommended.Td should be used instead.

For Td
• For injection dosage form:
  • For prevention of diphtheria and tetanus:
    • Children up to 7 years of age?Use is not recommended. DT shouldbe used instead.
    • Adults and children 7 years of age and over?One dose is givenat the first visit to the doctor, followed by a second dose four to eightweeks later. A third dose is given six to twelve months after the second dose.You should receive a booster dose every ten years. In addition, if you geta wound that is unclean or hard to clean, you may need an emergency boosterinjection if it has been more than five years since your last booster dose.The doses are injected into a muscle.

Side Effects of This Medicine

Along withits needed effects, a medicine may cause some unwanted effects. Although notall of these side effects may occur, if they do occur they may need medicalattention. It is very important that you tell your doctorabout any side effect that occurs after a dose of DT or Td, even ifthe side effect has gone away without treatment. Some types of side effectsmay mean that you should not receive any more doses of DT or Td.

Get emergency help immediatelyif any of the following side effects occur:

Rare?Symptoms of allergic reaction

Difficulty in breathing or swallowing; hives; itching, especially of feet or hands; reddening of skin, especially around ears; swelling of eyes, face, or inside of nose; unusualtiredness or weakness (sudden and severe)

Check with your doctor assoon as possible if any of the following side effects occur:

Rare

Confusion; convulsions (seizures); excessive sleepiness; fever over 39.4?C (103 ?F); headache or vomiting (severeor continuing); hives; itching; joint aches or pain; skin rash; swelling, blistering, pain, or other severereaction at the place of injection (generally starts within 2 to 8 hours afterthe injection); unusual irritability

Other sideeffects may occur that usually do not need medical attention. However, checkwith your doctor if any of the following side effects continue or are bothersome:

More common?For DT and Td

Redness or hard lump at the place of injection (this may last for a few days;however, less often, the hard lump may last for a few weeks)

More common?For DT only

Feverunder 39.4 ?C (103 ?F); swelling, pain, ortenderness at the place of injection (this may last for a few days)

Less common?For DT and Td

Dent or indentation at the place of injection

Less common?For DT only

Crying(continuing); drowsiness; fretfulness; loss of appetite; vomiting

Less common?For Td only

Chills; fast heartbeat; feverunder 39.4 ?C (103 ?F); general feeling ofdiscomfort or illness; headache; muscle aches; swelling of glands in armpit; unusual tiredness or weakness

Other side effects not listed above may also occur insome patients. If you notice any other effects, check with your doctor.