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Who should not get Tetanus vaccine?


vaccine who should not get

The tetanus toxoid vaccine is only available in combination with other routinely administered vaccines and most frequently combined with diphtheria (DT, Td) and acellular pertussis vaccines (DTaP, Tdap). It is also found in combination with vaccines for polio, haemophilus influenzae B (HIB), and hepatitis B.

The CDC’s Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of all infants and young children with the combination diphtheria, tetanus, and acellular vaccine (DTaP) at 2, 4, 6, 15-18 months, and 4 to 6 years, however, children under the age of seven with a contraindication to pertussis vaccination are recommended to receive the diphtheria-tetanus toxoid vaccine (DT) in place of the pertussis containing DTaP vaccine.1

According to the CDC, diphtheria, tetanus, and acellular pertussis vaccines (DTaP) should not be administered to any person who has experienced a severe allergic reaction to a previous dose or to anyone with a severe allergy to any ingredient found within the vaccine.2

If a person has a previous health history of Guillain-Barré Syndrome (GBS) within 6 weeks of receiving a dose of a tetanus toxoid containing vaccine, or is considered moderately or severe ill, the CDC recommends that vaccination be given only if the potential benefits to vaccination outweigh the possible risks. As well, anyone who has experienced an Arthus-type hypersensitivity reaction following a previous dose of a diphtheria or tetanus toxoid containing vaccine should not receive another tetanus-diphtheria (Td) vaccine more frequently than every 10 years.3

Any person who developed encephalopathy within seven days of vaccination with a pertussis containing vaccine (DTP, DTaP, Tdap) should not receive another pertussis containing vaccine (DTaP, Tdap).4

The CDC also states that additional doses of DTaP vaccines should only be administered when both parents and vaccine providers believe the potential benefits to vaccination outweigh the possible risks in children who have:5

  • Experienced a seizure within 3 days of a previous dose of DTP/DTaP vaccine
  • Developed a temperature of 105 F or higher within 2 days of previous vaccination with DTP/DTaP
  • Persistently cried for at least 3 hours or more within 48 hours of receiving a previous dose of DTP/DTaP
  • Collapsed or experienced a shock-like state within 2 days of a previous DTP/DTaP vaccine

Contraindications and precautions to vaccination as listed in the vaccine manufacturer product inserts

INFANRIX vaccine contraindications and precautions (Please see GlaxoSmithKline product insert for complete list):

  • Temperature of 105 F. or higher within 48 hours of a previous pertussis vaccination, not attributable to another identifiable cause;
  • Collapse or shock-like state (hypotonic-hyporesponsive episodes) within 48 hours of a previous pertussis vaccination;
  • Persistent crying lasting 3 hours or more within 48 hours of a previous pertussis vaccination;
  • Convulsions with or without fever, occurring within 3 days of a previous pertussis vaccination;
  • Serious allergic reaction to a previous pertussis vaccination;
  • Encephalopathy (coma, decreased level of consciousness, prolonged convulsions) within 7 days of a previous pertussis vaccination not attributable to another identifiable cause;
  • Children with a progressive neurologic disorder, including infantile spasms, uncontrolled epilepsy, or progressive encephalopathy;
  • Apnea following intramuscular vaccination has been observed in some infants born prematurely. Infanrix vaccine product insert warns that the decision to vaccinate an infant born prematurely should take into consideration both the potential risks and possible benefits of vaccination;
  • If Guillain-Barré syndrome (GBS) occurred within 6 weeks of receiving a tetanus containing vaccine, assessment of the possible risks and potential benefits of receiving Infanrix should be carefully considered prior to vaccination;
  • The tip caps of prefilled Infanrix syringes contain latex and may cause an allergic reaction in persons sensitive to latex.

INFANRIX is FDA approved for use in infants and children between 6 weeks through 6 years of age. INFANRIX should not be administered to infants younger than 6 weeks or children older than 6 years of age.

DAPTACEL vaccine contraindications and precautions (Please see Sanofi Pasteur product insert for complete list):

  • Temperature of 105 F. or higher within 48 hours of a previous pertussis vaccination, not attributable to another identifiable cause;
  • Collapse or shock-like state (hypotonic-hyporesponsive episodes) within 48 hours of a previous pertussis vaccination;
  • Persistent crying lasting 3 hours or more within 48 hours of a previous pertussis vaccination;
  • Convulsions with or without fever, occurring within 3 days of a previous pertussis vaccination;
  • Serious allergic reaction to a previous pertussis vaccination;
  • Encephalopathy (coma, decreased level of consciousness, prolonged convulsions) within 7 days of a previous pertussis vaccination not attributable to another identifiable cause;
  • Children with a progressive neurologic disorder (such as infantile spasms, uncontrolled epilepsy, or progressive encephalopathy);
  • Apnea following intramuscular vaccination has been observed in some infants born prematurely. DAPTACEL vaccine product insert warns that the decision to vaccinate an infant born prematurely should take into consideration both the potential risks and possible benefits of vaccination.
  • If Guillain-Barré syndrome (GBS) occurred within 6 weeks of receiving a tetanus containing vaccine, assessment of the possible risks and potential benefits of receiving DAPTACEL should be carefully considered prior to vaccination.

DAPTACEL is FDA approved for use in infants and children between 6 weeks through 6 years of age. DAPTACEL should not be administered to infants younger than 6 weeks or children older than 6 years of age.

Pediarix vaccine contraindications and precautions (Please see GlaxoSmithKline product insert for complete list):

  • Temperature of 105 F. or higher within 48 hours of a previous pertussis vaccination, not attributable to another identifiable cause;
  • Collapse or shock-like state (hypotonic-hyporesponsive episodes) within 48 hours of a previous pertussis vaccination;
  • Persistent crying lasting 3 hours or more within 48 hours of a previous pertussis vaccination;
  • Convulsions with or without fever, occurring within 3 days of a previous pertussis vaccination;
  • Serious allergic reaction to a previous pertussis vaccination;
  • Encephalopathy (coma, decreased level of consciousness, prolonged convulsions) within 7 days of a previous pertussis vaccination not attributable to another identifiable cause;
  • Children with a progressive neurologic disorder (such as infantile spasms, uncontrolled epilepsy, or progressive encephalopathy);
  • Sensitivity to any component of Pediarix, including yeast or neomycin and polymyxin B (antibiotics);
  • Apnea following intramuscular vaccination has been observed in some infants born prematurely. Pediarix vaccine product insert warns that the decision to vaccinate an infant born prematurely should take into consideration both the potential risks and possible benefits of vaccination.
  • The tip caps of prefilled Pediarix syringes contain latex and may cause an allergic reaction in persons sensitive to latex;
  • If Guillain-Barré syndrome (GBS) occurred within 6 weeks of receiving a tetanus containing vaccine, assessment of the possible risks and potential benefits of receiving Pediarix should be carefully considered prior to vaccination.

Pediarix is FDA approved for use in infants and children between 6 weeks through 6 years of age. Pediarix should not be administered to infants younger than 6 weeks or children older than 6 years of age.

Kinrix vaccine contraindications and precautions (Please see GlaxoSmithKline product insert for complete list):

  • Temperature of 105 F. or higher within 48 hours of a previous pertussis vaccination, not attributable to another identifiable cause;
  • Collapse or shock-like state (hypotonic-hyporesponsive episodes) within 48 hours of a previous pertussis vaccination;
  • Persistent crying lasting 3 hours or more within 48 hours of a previous pertussis vaccination;
  • Convulsions with or without fever, occurring within 3 days of a previous pertussis vaccination;
  • Serious allergic reaction to a previous pertussis vaccination;
  • Encephalopathy (coma, decreased level of consciousness, prolonged convulsions) within 7 days of a previous pertussis vaccination not attributable to another identifiable cause;
  • Children with a progressive neurologic disorder (such as infantile spasms, uncontrolled epilepsy, or progressive encephalopathy);
  • Severe allergic reaction to any component of Kinrix, including neomycin and polymyxin B (antibiotics);
  • The tip caps of prefilled Kinrix syringes contain latex and may cause an allergic reaction in persons sensitive to latex;
  • If Guillain-Barré syndrome (GBS) occurred within 6 weeks of receiving a tetanus containing vaccine, assessment of the possible risks and potential benefits of receiving Kinrix should be carefully considered prior to vaccination.

Kinrix is FDA approved for use in children between the ages of 4 and 6 years. Kinrix should not be administered to children younger than 4 years or older than 6 years of age.

Quadracel vaccine contraindications and precautions (Please see Sanofi Pasteur product insert for complete list):

  • Serious allergic reaction following administration of a pertussis, tetanus, diphtheria, or polio containing vaccine or any ingredient of Quadracel vaccine;
  • Encephalopathy (coma, decreased level of consciousness, prolonged convulsions) within 7 days of a previous pertussis vaccination not attributable to another identifiable cause;
  • Children with a progressive neurologic disorder (such as infantile spasms, uncontrolled epilepsy, or progressive encephalopathy);
  • Seizures within 3 days of a previous pertussis vaccination;
  • Temperature of 105 F. or higher within 48 hours of a previous pertussis vaccination, not attributable to another identifiable cause;
  • If Guillain-Barré syndrome (GBS) occurred within 6 weeks of receiving a tetanus containing vaccine, assessment of the possible risks and potential benefits of receiving Quadracel should be carefully considered prior to vaccination.

Quadracel is FDA approved for use in children between the ages of 4 and 6 years. Quadracel should not be administered to children younger than 4 years or older than 6 years of age.

Pentacel vaccine contraindications and precautions (Please see Sanofi Pasteur product insert for complete list):

  • Temperature of 105 F. or higher within 48 hours of a previous pertussis vaccination, not attributable to another identifiable cause;
  • Collapse or shock-like state (hypotonic-hyporesponsive episodes) within 48 hours of a previous pertussis vaccination;
  • Persistent crying lasting 3 hours or more within 48 hours of a previous pertussis vaccination;
  • Convulsions with or without fever, occurring within 3 days of a previous pertussis vaccination;
  • Serious allergic reaction to a previous pertussis vaccination;
  • Encephalopathy (coma, decreased level of consciousness, prolonged convulsions) within 7 days of a previous pertussis vaccination not attributable to another identifiable cause;
  • Children with a progressive neurologic disorder (such as infantile spasms, uncontrolled epilepsy, or progressive encephalopathy)
  • Severe allergic reaction to any component of Pentacel, including neomycin and polymyxin B (antibiotics);
  • Apnea following intramuscular vaccination has been observed in some infants born prematurely. Pentacel vaccine product insert warns that the decision to vaccinate an infant born prematurely should take into consideration both the potential risks and possible benefits of vaccination;
  • If Guillain-Barré syndrome (GBS) occurred within 6 weeks of receiving a tetanus containing vaccine, assessment of the possible risks and potential benefits of receiving Pentacel should be carefully considered prior to vaccination.

Pentacel is FDA approved for use in infants and children between 6 weeks through 4 years of age. Pentacel should not be administered to infants younger than 6 weeks or children older than 4 years of age.

VAXELIS vaccine contraindications and precautions (Please see MCM Vaccine Company product insert for complete list):

  • Temperature of 105 F. or higher within 48 hours of a previous pertussis vaccination, not attributable to another identifiable cause;
  • Collapse or shock-like state (hypotonic-hyporesponsive episodes) within 48 hours of a previous pertussis vaccination;
  • Persistent crying lasting 3 hours or more within 48 hours of a previous pertussis vaccination;
  • Convulsions with or without fever, occurring within 3 days of a previous pertussis vaccination;
  • Serious allergic reaction to a previous dose of VAXELIS, any ingredient found in VAXELIS, or any other tetanus toxoid, diphtheria toxoid, pertussis-containing vaccine, hepatitis B vaccine, inactivated poliovirus vaccine, or H. influenzae type b vaccine;
  • Encephalopathy (coma, decreased level of consciousness, prolonged convulsions) within 7 days of a previous pertussis vaccination not attributable to another identifiable cause;
  • Children with a progressive neurologic disorder (such as infantile spasms, uncontrolled epilepsy, or progressive encephalopathy);
  • Apnea following intramuscular vaccination has been observed in some infants born prematurely. VAXELIS vaccine product insert warns that the decision to vaccinate an infant born prematurely should take into consideration both the potential risks and possible benefits of vaccination;
  • If Guillain-Barré syndrome (GBS) occurred within 6 weeks of receiving a tetanus containing vaccine, assessment of the possible risks and potential benefits of receiving VAXELIS should be carefully considered prior to vaccination.

VAXELIS is FDA approved for use in infants and children between 6 weeks through 4 years of age. VAXELIS should not be administered to infants younger than 6 weeks or children older than 4 years of age.

Diphtheria and Tetanus Toxoid Adsorbed vaccine contraindications and precautions (Please see Sanofi Pasteur product insert for complete list):

  • Serious allergic or hypersensitivity reaction to a previous shot, or to any diphtheria or tetanus toxoid vaccine;
  • Apnea following intramuscular vaccination has been observed in some infants born prematurely. Diphtheria and Tetanus Toxoid Absorbed vaccine product insert warns that the decision to vaccinate an infant born prematurely should take into consideration both the potential risks and possible benefits of vaccination;
  • If Guillain-Barré Syndrome (GBS) occurred within 6 weeks of a previous tetanus toxoid vaccine, the risk of a recurrent case may be increased following vaccination with Diphtheria and Tetanus Toxoid Adsorbed.

Diphtheria and Tetanus Toxoid Adsorbed is FDA approved for use in infants and children between 6 weeks through 6 years of age. Diphtheria and Tetanus Toxoid Adsorbed should not be administered to infants younger than 6 weeks or children older than 6 years of age.

Adacel vaccine contraindications and precautions (Please see Sanofi Pasteur product insert for complete list):

  • Moderate or severe acute illness (with or without fever) until the illness resolves;
  • Serious allergic or hypersensitivity reaction to a previous shot;
  • Encephalopathy (coma, decreased level of consciousness, prolonged convulsions) within 7 days of a previous pertussis vaccination not attributable to another identifiable cause;
  • In adolescents, a progressive neurologic disorder, including progressive encephalopathy or uncontrolled epilepsy (convulsions);
  • In adults, an unstable neurologic condition, such as cerebrovascular events and acute encephalopathic conditions;
  • If Guillain-Barré Syndrome (GBS) occurred within 6 weeks of a previous tetanus toxoid vaccine, the decision to administer Adacel should carefully examine the possible risk and benefits of Adacel prior to vaccination;
  • Anyone who has experienced an Arthus-type hypersensitivity reaction following a previous dose of a tetanus toxoid vaccine should not receive Adacel more frequently than every 10 years;
  • The tip caps of prefilled Adacel syringes contain latex and may cause an allergic reaction in persons sensitive to latex.

Adacel is approved to be administered in persons between the ages of 10 and 64 years of age. A second dose of Adacel may be administered if there has been an interval of at least eight years between a prior Tdap vaccine dose.  Adacel should not be administered to children younger than 10 years or adults older than 64 years.

Boostrix vaccine contraindications and precautions (Please see GlaxoSmithKline product insert for complete list):

  • Serious allergic or hypersensitivity reaction to a previous shot;
  • Encephalopathy (coma, decreased level of consciousness, prolonged convulsions) within 7 days of a previous pertussis vaccination not attributable to another identifiable cause;
  • In adolescents and adults, a progressive neurologic disorder, including progressive encephalopathy or uncontrolled epilepsy (convulsions);
  • If Guillain-Barré Syndrome (GBS) occurred within 6 weeks of a previous tetanus toxoid vaccine, the decision to administer Boostrix should carefully examine the possible risk and benefits of vaccination;
  • Anyone who has experienced an Arthus-type hypersensitivity reaction following a previous dose of a tetanus toxoid vaccine should not receive Boostrix more frequently than every 10 years;
  • The tip caps of prefilled Boostrix syringes contain latex and may cause an allergic reaction in persons sensitive to latex.

Boostrix is approved to be administered as a single dose in persons older than 10 years. Boostrix should not be administered to children younger than 10 years of age.

TDVAX vaccine contraindications and precautions (Please see MassBiologics product insert for complete list):

  • Serious allergic or hypersensitivity reaction to a previous shot, or to any diphtheria or tetanus toxoid vaccine;
  • If Guillain-Barré Syndrome (GBS) occurred within 6 weeks of a previous tetanus toxoid vaccine, the decision to administer TDVAX should carefully examine the possible risk and benefits prior to vaccination;
  • Anyone who has experienced an Arthus-type hypersensitivity reaction following a previous dose of a tetanus toxoid vaccine should not receive TDVAX more frequently than every 10 years.

TDVAX is approved for use in adults and children 7 years of age and older. TDVAX should not be administered to children younger than 7 years.

TENIVAC vaccine contraindications and precautions (Please see Sanofi Pasteur product insert for complete list):

  • Serious allergic or hypersensitivity reaction to a previous shot, or to any diphtheria or tetanus toxoid vaccine;
  • If Guillain-Barré Syndrome (GBS) occurred within 6 weeks of a previous tetanus toxoid vaccine, the decision to administer TENIVAC should carefully examine the possible risk and benefits prior to vaccination;
  • Anyone who has experienced an Arthus-type hypersensitivity reaction following a previous dose of a tetanus toxoid vaccine should not receive TENIVAC more frequently than every 10 years;
  • The tip caps of prefilled TENIVAC syringes contain latex and may cause an allergic reaction in persons sensitive to latex;
  • Administering TENIVAC vaccine more frequently than prescribed may result in the increased incidence and severity of adverse reactions.

TENIVAC is approved for use in adults and children 7 years of age and older. TENIVAC should not be administered to children younger than 7 years.

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.

« Return to Vaccines & Diseases Table of Contents

References

1 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

2 CDC Diphtheria, Tetanus, and Pertussis Vaccine Recommendations – Contraindications and Precautions Dec. 17, 2018

3 Ibid

4 Ibid

5 Ibid


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