Vaccination Schedule for Adults and Adolescents

Medical Authors: Carolyn J. Crandall, MD, and Daniel Gornel, MD, MPH
Medical Editor: Dennis Lee, MD

• Tetanus and diphtheria toxoids (Td)
• Influenza vaccine (flu shot)
• Pneumococcal polysaccharide vaccine
• Hepatitis A Vaccine
• Hepatitis B Vaccine
• MMR (Measles-Mumps-Rubella)
• Poliovirus
• Varicella (chickenpox) vaccine

TETANUS AND DIPHTHERIA TOXOIDS (TD) VACCINE

Tetanus and diphtheria toxoids (TD) is a combination vaccine to prevent tetanus (also known as "lockjaw") and diphtheria.

Who should receive the tetanus and Td vaccine?

Adults and adolescence.

How often should the tetanus and Td vaccine be administered?

• Adults who had received recommended childhood immunizations should have a Td shot every 10 years
• Adults who have never received childhood vaccinations should receive three Td shots (the second shot in 4-8 weeks after the first, and the third shot at 6-12 months after the second shot)
• Adults at higher risk of contracting tetanus (adults working with farm manure or home garden manure fertilizers) should have a Td shot every 5 years
• Individuals with a clean, minor wound who has had less than three Td shots or of uncertain vaccination history should receive a Td shot
• Individuals with more serious wounds (wounds from burns, crushing, frostbite) or wounds contaminated with dirt, feces, or saliva should have both Td and tetanus immune globulin if the individual had less than 3 shots or uncertain vaccination history, and Td alone if he/she had 3 or more shots but the last one was more than 5 years ago

What about pregnancy and breastfeeding?

The vaccine can be given during pregnancy and lactation except during first trimester of pregnancy.

Who should not receive the tetanus and Td vaccine?

• Individuals who have had prior severe vaccine reactions such as seizures, brain dysfunction, high fever (>104.9 F), anaphylaxis, or shock should not receive additional Td vaccine
• The vaccine should not be given to women in the first trimester of pregnancy

What is the effectiveness of the tetanus and Td vaccine, and what about side effects?

• The vaccine is highly effective against both tetanus and diphtheria when given according to the recommended schedule
• Side effects include redness and tenderness at the injection site, fever and malaise can sometimes occur. Severe rash, anaphylactic shock, seizure and brain dysfunction have been reported but are very rare

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