Who is at highest risk for complications from Tetanus vaccine?
There is a gap in medical knowledge in terms of doctors being able to predict who will have an adverse reaction to tetanus vaccination, and who will not.
Persons with a history of Guillain-Barre Syndrome (GBS) within 6 weeks of receiving a tetanus containing vaccine may be at an increased risk of recurrent GBS illness following tetanus vaccination.1 2 3 4 5 6 7 8 9 10 11 12
Anyone who has experienced an Arthus-like reaction (severe painful swelling of the injected arm) following a previous dose of tetanus toxoid vaccine are also considered to be at a greater risk of recurrent reaction and should not be vaccinated with tetanus toxoid vaccine more frequently than every 10 years.13
Infants born prematurely have been noted to experience apnea following intramuscular vaccination, placing them at higher risk for complications following vaccination. DTaP and DT vaccine product inserts state that the decision to vaccinate an infant born prematurely should take into consideration health status and the possible risks and potential benefits of vaccination.14 15 16 17 18 19
Residual milk allergens may persist following the manufacturing of DTaP and Tdap vaccines. While the CDC’s Advisory Committee on Immunization Practices (ACIP) does not consider a milk allergy to be a contraindication to vaccination and recommends both DTaP and Tdap vaccines for persons with known milk allergies, it does, however, strongly advise the monitoring of milk allergic patients due to the potential risk of anaphylaxis.20
Pre-licensing clinical studies of Adacel vaccine (Tdap) reported that when the vaccine was administered concomitantly with the Hepatitis B vaccine, there were an increase in reports of redness and swelling at the injection site and an increase of reports of swollen joints and body aches. Additionally, when Adacel was administered with the trivalent inactivated influenza vaccine (TIV), Fluzone, pain at the injection site was noted to be statistically higher when compared to the separate administration of Adacel vaccine. Rates of joint pain and swelling were also noted to be higher when Adacel was administered concurrently with Fluzone. As a result, persons who receive simultaneous vaccinations with one or more vaccines may be at a higher risk for adverse events.21
The TENIVAC (Td) vaccine product insert states that administering the vaccine more frequently than prescribed may result in the increased incidence and severity of adverse reactions.22
IMPORTANT NOTE: NVIC encourages you to become fully informed about Tetanus and the Tetanus vaccine by reading all sections in the Table of Contents , which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.
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1 FDA Boostrix Product Insert Apr. 25, 2016
2 FDA Adacel Product Insert Jan. 11, 2019
3 FDA TENIVAC Product Insert Oct. 25, 2013
4 FDA TDVAX Product Insert Nov. 15, 2018
5 FDA Infanrix Product Insert Apr. 28, 2016
6 FDA DAPTACEL Product Insert Sep. 14, 2016
7 FDA Pediarix Product Insert Apr. 25, 2016
8 FDA Kinrix Product Insert Apr. 25, 2016
9 FDA Quadracel Product Insert Mar. 24, 2015
10 FDA VAXELIS Product Insert Dec. 21, 2018
11 FDA Pentacel Product Insert Mar. 16, 2017
12 FDA Diphtheria and Tetanus Toxoids Adsorbed Product Insert Dec. 18, 2018
13 CDC Tetanus - Adverse Events Following Vaccination Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.
14 FDA Infanrix Product Insert Apr. 28, 2016
15 FDA DAPTACEL Product Insert Sep. 14, 2016
16 FDA Pediarix Product Insert Apr. 25, 2016
17 FDA Pentacel Product Insert Mar. 16, 2017
18 FDA VAXELIS Product Insert Dec. 21, 2018
19 FDA Diphtheria and Tetanus Toxoids Adsorbed Product Insert Dec. 18, 2018
20 CDC Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Apr. 27, 2018; 67(2);1–44
21 FDA Adacel Product Insert Jan. 11, 2019
22 FDA TENIVAC Product Insert Oct. 25, 2013