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Immunization : Tetanus and Diphtheria (Td) Vaccine

Vaccines (injections or shots) are the best way to protect against some very serious infections. The National Advisory Committee on Immunization strongly recommends that all Canadians receive a primary immunizing course of tetanus toxoid in childhood followed by routine booster doses every 10 years.

Td is a two-in-one vaccine. It protects people against tetanus and diphtheria. It is recommended for persons 7 years or older. Vaccination against tetanus and diphtheria is required by law for all children attending school in Ontario (unless exempted).

What is tetanus?

Tetanus or lockjaw is a serious disease that can happen if dirt with the tetanus germ gets into a cut in the skin. Tetanus germs are found everywhere, usually in soil, dust and manure. It does not spread from person to person. Tetanus causes cramping of the muscles in the neck, arms, leg and stomach, and painful convulsions which can be severe enough to break bones. Even with early treatment, tetanus kills two out of every 10 people who get it.

What is diphtheria?

Diphtheria is a serious disease of the nose, throat and skin. It causes sore throat, fever and chills. It can be complicated by breathing problems, heart failure and nerve damage. Diphtheria kills about one out of every 10 people who get the disease. It is most often passed to others through coughing and sneezing.

How well does Td vaccine protect against tetanus and diphtheria?

When Td vaccine is given in the recommended number of shots, it protects virtually 100 per cent of people against tetanus and over 95 per cent of people against diphtheria. Vaccination also makes these diseases milder for those who may catch them.

When should Td vaccine be given?

Most people get vaccinated against tetanus and diphtheria in early childhood. Around the 15th birthday a booster shot is given to people who were vaccinated against tetanus and diphtheria at an early age. This "booster" dose also contains pertussis vaccine (Tdap). Adults should get Td vaccine boosters every 10 years for continued protection.

Is the Td vaccine safe?

Yes. Side effects of the Td vaccine are mild and last for only few days after getting the shot. Mild pain, swelling and redness are common at the spot where the shot was given. A few people may get a mild fever, lose their appetite or feel tired for a day or two after the shot. You should always discuss the benefits and risks of any vaccine with your doctor/nurse practitioner.

When should I call my doctor/nurse practitioner?

Call your doctor/ nurse practitioner or go to the nearest hospital emergency department if any of the following symptoms develop within three days of getting the shot:

hives;
swelling of the face or mouth;
trouble breathing;
very pale colour and serious drowsiness;
high fever (over 40°C or 104°F);
convulsions or seizures;
other serious problems.

Who should not get the Td vaccine?

The doctor/nurse practitioner may decide not to give the Td vaccine if the person:

has a high fever or serious infection worse than a cold;
has had a serious allergic reaction (anaphylaxis) to this vaccine or any part of a tetanus or diphtheria containing vaccine in the past;
had a severe allergic reaction to any component of the vaccine;
had a tetanus shot in the last 5 years;
is a child less than 7 years of age.

Who should I talk to if I have any more questions about the Td vaccine?

Talk to your doctor/nurse practitioner or call your local public health unit for more information.

Your record of protection

After any immunization, make sure your personal immunization record (i.e., the "yellow card") is updated. If your child is attending child care or school, inform your local public health unit each time your child receives an immunization. An immunization record is required for child care and school attendance and for certain types of travel and work, so keep it in a safe place.

June 2009