Diphtheria and Tetanus Vaccine (Intramuscular)

Diphtheria and Tetanus Vaccine deactivates the infection by prompting the immune system to produce antibodies against these diseases.


Routine tetanus diphtheria (Td) vaccinations have eradicated the tetanus (lockjaw) and diphtheria infections. The vaccine is a mixture containing inactive toxins produced by the bacteria responsible for causing the diseases. It works by stimulating the body's immune system to produce protective antibodies to fight the diseases. Td is a recommended booster, administered every 10 years helping the immune system to protect against the disease.

  • Do not confuse this vaccine with the tetanus, diphtheria and pertussis (Tdap) vaccination, which includes a third form of bacterial disease known as acellular pertussis (whooping cough).

Diphtheria can be fatal, causing breathing and heart problems, nerve damage and pneumonia. Young children and elderly are at high risks when encountering this infection, primarily due to weaker immune systems. Tetanus is also fatal, causing seizures and breathing and swallowing difficulties. The triggers are muscle spasms causing the muscles to stiffen. When the condition is severe, bone fractures in the spine occur.

Before taking this injection, you need to understand the precautions pertaining to your immune system.

  • If you have experienced an allergic reaction to an earlier dose your doctor may not recommend this vaccine for you.
  • If you suffer from autoimmune disorders (inherited or acquired) you should not take this vaccine.
  • If you are ill on the day you're scheduled for the vaccine reschedule the appointment.

The U.S. Food and Drug Administration (FDA) approved Td for wound management using tetanus and diphtheria toxoids for individuals over seven years of age. Td will not treat an active infection. If you or your children have an infection due to tetanus or diphtheria contact your doctor immediately.

Conditions Treated

  • Diphtheria and Tetanus

Type Of Medicine

  • Immunizing agent

Side Effects

All medicines have some level of side effects that vary from person to person, depending on the individuals' health, age and the phase of infection caused by exposure to these two diseases. Today, these diseases are controlled and injections are given every 10 years, with booster shots as needed.

The vaccine contains inactive toxins produced by the bacteria responsible for causing the diseases. The first series of injections prompts the body to create protective antibodies, strengthening your immunity against the toxins. As time passes, the immunity strength will decrease or weaken, added doses are necessary and must be given under the supervision of a doctor.

  • The vaccine is administered to children older than 7 years of age, adolescents (teenagers) and adults.

The side effects associated with this vaccine are mild with rare or serious reactions in some situations. Here's a list of the most common, least common and rare side effects that have occurred. Your own body's composition may trigger an effect not listed if it occurs, talk to your doctor. If you experience any of these past your comfort level, talk to your doctor. If the effects worsen or persist beyond a week, the cause may be an underlying condition that needs your doctor's attention.

Most common

  • Tenderness at the injection site
  • Fainting or dizziness after the injection
  • Stiffness in the arm after injection

Although the side effects occur, medical attention is not always needed. For some the site of injection is sensitive, causing pain and redness. After the injection, you may need to lie down for 15 minutes and allow your body to regain its composure. In most situations, the side effects fade and your doctor will have suggestions to prevent or reduce them.

Not everyone experiences these effects. Take a few minutes to talk with your doctor, based on your health and medical history; sometimes the doctor can predict how your body may react. These effects are least common, but they can happen. The effects involve different levels of discomfort or pain for some individuals. If any of these occur, you need to seek medical attention. These effects may be signs of other body ailments associated the vaccine's side effects.

Least Common

  • Bloating
  • Breathing problems
  • Burning
  • Change in weight
  • Cough
  • Swallowing problems
  • Fatigue
  • Fever
  • Headache
  • Hives
  • Itching

These side effects are rare, and most individuals do not experience these effects, but they will affect your reaction to the vaccine. If you are taking medications for other ailments, you may experience a reaction between the two drugs. Talk with your doctor before complications develop into harmful illnesses.


  • Convulsions
  • Irregular heartbeat
  • Joint pain
  • Nausea
  • Swollen joints
  • Tiredness
  • Vomiting

Levels of discomfort will intensify triggering sensitivities or allergies when taking other medications. Some effects occur instantaneously, others appear throughout the series of treatment. Many will subside after each cycle of injection, and most diminish after the final series of injections are completed.


A trained health professional administers the vaccination into your arm muscle. The injection site is the upper arm near your shoulder, not the gluteal (buttocks) muscles or a major nerve trunk.

The first two doses are coordinated 4 to 8 weeks apart and the third is scheduled 6 to 12 months after the second dose. Each dose is 0.5 milliliters (ml). The doctor may adjust the doses to prevent side effects. If the dosage is lowered, you can expect the series timeframe to be extended to make sure you receive ample measurements to protect against infection.

Primary Td immunizations

  • Adults: 3 doses
  • Adolescents: 3 doses
  • Children: 3 to 4 doses

On your doctor's recommendation, the Tdap injection may be administered in place of the Td as a primary immunization. The Td booster is still ordered as a 10-year follow-up. Talk with the doctor to understand why the Tdap shot is selected as the primary with the Td booster shot.

  • Td vaccinations may not protect all individuals.
  • Patients younger than 7 years of age should not receive this vaccine.
  • Doctor may reduce the dosage or discontinue the series for individuals experiencing adverse reactions.


Drug interactions change the effects, results and the risks of preventative vaccines. In most circumstances, medicines work well together to manage multiple health conditions. There are situations where two different medicines interact with each other and cause serious effects. Sometimes, health disorders like unknown allergies can instigate these interactions.

Share all your medical history and the medications you are taking now with your doctor. If you are taking any of these listed medications, tell your doctor. Drug interactions increase the risk of harmful side effects and the reaction can interfere with the vaccine's purpose, leaving you susceptible to these fatal diseases. Your doctor may suggest a change of dosage as part of the therapy management for using both medicines.

  • Acetaminophen
  • Alprazolam
  • Colace
  • Dextroamphetamine
  • Dilantin
  • Enbrel
  • Ketorolac
  • Levothyroxine
  • Lidocaine
  • Nexium
  • Pepcid
  • Plavix
  • Protonix
  • Symbicort
  • Vitamin B12
  • Zantac
  • Zofran
  • Zyrtec

Other Interactions

Allergies pose serious health threats for many individuals scheduled for the Td vaccine, because the pre-filled syringes or the bottle of the vaccine may contain natural rubber latex, known to cause allergic reactions. You need to let your doctor know if you are sensitive to latex.

Immunosuppressive therapy will reduce immune responses to vaccines. It's important to let your doctor know before scheduling your primary immunization or booster shots.

  • Alkylating agents
  • Antimetabolites
  • Cytotoxic drugs
  • Irradiation

Different medicines and foods trigger interactions with medicines. Be sure to read the vaccine's informational instructions or talk to your doctor if you have questions. Alcohol or tobacco may diffuse the medicine's effect and cause severe interactions with this medication. If you take over-the-counter (OTC) medicines, they will affect your response to the vaccine. It's best not to take other medicines without talking to your doctor first.

Other Medical Problems

Health conditions or other medical problems can affect this vaccine. Let your doctor know if you suffer from any of these conditions. Your doctor will decide, whether this vaccine should be administered to you.

  • Known allergy to the vaccine
  • Guillain-Barre' syndrome
  • Inherited history of immunodeficiency disorder
  • Acquired secondary immune disorder


Posted warnings, precautions and guidelines for both professional practitioners and consumers is based other medicines sharing similar vaccine components causing adverse reactions. It's critical to tell you doctor about medications you are taking now.

Noted reports related to the frequency of administering this vaccine involve general disorders with mild to severe incidents, depending on the individual's health, age and seriousness of the infection.

  • Vaccine injection site: pain, sensitivity or inflammation
  • Nervous system: headaches or dizziness
  • Musculoskeletal: stiffness or pain
  • Skin: rash, bacterial infection
  • Gastrointestinal nausea

Before scheduling this vaccine, you need to understand the benefits and the risks associated with the immunization of Td. Most important is learning why completing the primary series and maintaining the scheduled booster shots help to improve your long-term health.

Medical Studies

Although the vaccine has achieved its effectiveness against the diseases there are serious warnings to an individual's health. The safety and effectiveness for individuals with these conditions has not been established.

  • Impairment of fertility concerns about weakening reproductive systems is inconclusive.
  • Pregnancy category C: this vaccine should not be given to pregnant women or women trying to get pregnant.
  • Nursing mothers: unknown effects and precautions involve passing traces of the Td vaccine to the infant.
  • Geriatric: 65-year-old adults or older show no signs in responding differently compared to younger age individuals.


Health care staff or professional care providers are responsible for storing this medicine. In preparation for administering, it is stored at temperatures 36 to 46 Fahrenheit.

  • This vaccine should not be frozen. If freezing occurs, the vaccine is destroyed.
  • Used medical supplies and unused portions are disposed of according to healthcare guidelines.


The vaccine has achieved its effectiveness with maintenance of primary doses and boosters of Td. There is a 99 percent success rate when individuals complete the primary series and continue with boosters. In some situations, individuals missing the booster shots have avoided an incident.