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# Tetanus vaccine (tetanus toxoid)

Inactivated tetanus toxin that induces protective antibodies. It prevents tetanus, including neonatal tetanus, and is usually combined with diphtheria vaccine.

Updated 2026-11-01

- Class: [Bacterial and antimalarial vaccines](https://durgical.com/en/pharmacology/classes/bacterial-and-antimalarial-vaccines/)
- Target: Immune response against tetanospasmin (tetanus toxin)
- ATC code: J07AM01
- WHO Model List of Essential Medicines

Also called: Tetanus toxoid, TT, Td (combined with diphtheria toxoid)

◆**Immune response against tetanospasmin (tetanus toxin)**Tetanus vaccine (tetanus toxoid)

ⓘ The figure shows Clostridium tetani tetanus neurotoxin bound to the ganglioside GD1a, its receptor on neurons. The vaccine contains this toxin in inactivated form (toxoid).

**Target in 3D:** Immune response against tetanospasmin (tetanus toxin). PDB structure 5N0B (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/5N0B) · Drag to rotate · pinch to zoom

## Mechanism of action

The toxoid is inactivated tetanospasmin: it no longer blocks release of inhibitory neurotransmitters but keeps its epitopes. It induces IgG that neutralises the toxin if Clostridium tetani spores germinate in a wound. The disease itself leaves no immunity, because the amount of toxin that causes it is too small to trigger a response.

- Toxoid (inactivated toxin) is injected into muscle
- B and T cells recognise its epitopes and form memory
- Circulating IgG neutralises toxin before it reaches the neuron
- Boosters keep antibody levels up throughout life

## Pharmacokinetics

**Distribution**
Vaccine-induced maternal IgG crosses the placenta and protects the newborn

**Onset and duration**
Protection builds with the primary series and is maintained with boosters

## Indications

- Prevention of tetanus in the childhood series, combined with diphtheria and pertussis
- Vaccination of women of reproductive age and pregnant women to prevent neonatal tetanus
- Wound management when vaccination history is incomplete or unknown, together with tetanus immunoglobulin if the wound is not clean and minor

## Adverse effects

### Common

- Pain, redness and swelling at the injection site
- Low-grade fever and malaise

### Serious (rare, important)

- Exaggerated Arthus-type local reaction (rare), mainly with very frequent boosters
- Anaphylaxis (very rare)

## Contraindications

- Previous anaphylaxis to a dose or to a vaccine component
- Precaution: history of an Arthus-type reaction to a toxoid; the next booster is deferred

## Key interactions

**Tetanus immunoglobulin**
Used together for tetanus-prone wounds: the immunoglobulin protects at once and the toxoid starts or completes the body's own immunity

## What is monitored

- Vaccination history (number of previous doses) before managing a wound
- Local reaction over the following hours

## Administration and safety

- Intramuscular route
- With tetanus immunoglobulin, at a different anatomical site and with a different syringe
- Check whether the product is toxoid alone or combined (Td, DTP) before giving it

## Nursing care

- Ask about and record previous tetanus toxoid doses
- Classify the wound (clean and minor or tetanus-prone) to decide whether immunoglobulin is added
- Observe the patient for a few minutes after vaccination for allergic reaction
- Explain that local pain and low fever are expected and short-lived

## Pregnancy and breastfeeding

Recommended in pregnancy when the woman is not protected: it is the basis of neonatal tetanus prevention.

## Memory aid

"Having tetanus doesn't cure tetanus": survivors get vaccinated, because the toxin dose that makes you ill is too small to immunise.

## Test yourself

Think of the answer, then tap the question to see it.

## Why should a person who survived tetanus be vaccinated?

The toxin is so potent that the amount causing disease is not enough to induce antibodies; without vaccination the person remains unprotected.

## How does the vaccine prevent neonatal tetanus?

By vaccinating women of reproductive age or during pregnancy: antitoxin IgG crosses the placenta and protects the newborn, alongside clean delivery and cord care.

## According to WHO, how many doses of tetanus-toxoid-containing vaccine give lifelong protection?

Six: three primary doses plus three boosters.

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## Related drugs

- [Human tetanus immunoglobulin](https://durgical.com/en/pharmacology/human-tetanus-immunoglobulin/)
- [Diphtheria vaccine (diphtheria toxoid)](https://durgical.com/en/pharmacology/diphtheria-vaccine/)
- [Pertussis vaccine](https://durgical.com/en/pharmacology/pertussis-vaccine/)

[← Back to the class: Bacterial and antimalarial vaccines](https://durgical.com/en/pharmacology/classes/bacterial-and-antimalarial-vaccines/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Tetanus](https://www.who.int/news-room/fact-sheets/detail/tetanus) (World Health Organization, 2026); [Chapter 21: Tetanus | Pink Book | CDC](https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-21-tetanus.html) (Centers for Disease Control and Prevention, 2021); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=J07AM01) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025).

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Representative model, for educational purposes only.

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