Tetanus-diphtheria (Td) vaccine protects against tetanus and diphtheria, which are bacterial infections. The bacteria that cause these infections produce harmful substances called toxins that can cause serious health problems.
Typically, the tetanus bacteria enter the body through a wound and begin to grow and produce the toxin. The toxin causes severe muscle spasms and can be fatal. Therefore, vaccination is particularly important.
Diphtheria usually causes inflammation of the throat and mucous membranes of the mouth. Also, the bacteria that cause diphtheria produce a toxin that can damage the heart, kidneys, and nervous system. Before routine vaccination became available, diphtheria was a leading cause of death in children.
Vaccine Type
The Td vaccine is a toxoid vaccine, which means it contains the toxins that are produced by the bacteria that cause tetanus or diphtheria but have been modified to be harmless. Because the toxoids are harmless, they can cannot cause tetanus or diphtheria, but they do trigger a strong response from a person's immune system (see Active immunization).
The Td vaccine is only for people 7 years of age and older (mostly adolescents and adults).
There are also 2 combination vaccines that add protection against pertussis. One is for children under 7 years old and is called DTaP. This other is for adolescents and adults and is called Tdap.
Dose of and Recommendations for Tetanus-Diphtheria Vaccine
Td vaccine is injected into a muscle.
People who should get this vaccine
The combination diphtheria-tetanus-pertussis (DTaP) vaccine is a routine childhood vaccination. Five total shots of DTaP are given typically at age 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years (see Centers for Disease Control and Prevention [CDC]: Recommended Immunizations for Birth Through 6 Years Old, United States, 2025). This combination vaccine is given in 5 injections (at age 2 months, 4 months, 6 months, 12 to 18 months, and 4 to 6 years).
After children complete the DTaP vaccine series, they are given 1 booster dose of Tdap vaccine at age 11 to 12 years. Because immunity against pertussis is decreasing, people over age 16 should receive the Tdap booster if they have not received it previously.
The Td or Tdap vaccine is given as 1 booster dose every 10 years after the Tdap booster is given at age 11 to 12 years.
Because tetanus can develop after a wound or after an injury that breaks the skin becomes contaminated, people who have received the Tdap vaccine and have a wound may be given 1 dose of Td or Tdap vaccine to prevent tetanus from developing if 5 years or more have passed since their last dose. People over the age of 7 who have not received the Tdap vaccine and have a wound are given the Tdap vaccine.
People who should not get this vaccine
People who have had a serious, life-threatening allergic reaction (such as an anaphylactic reaction) after a previous dose of the Td vaccine or to an component in the vaccine should not receive it.
Additionally, people who have any of the following problems should not receive Td vaccine:
Development of Guillain-Barré syndrome within 6 weeks of receiving a vaccine that protects against tetanus
Severe pain or swelling after a previous dose of any vaccine that protects against tetanus or diphtheria
If people have a temporary illness, doctors usually wait to give the vaccine until the illness resolves.
Certain other conditions may affect whether and when people are vaccinated (see also CDC: Who Should NOT Get Vaccinated With These Vaccines?).
Side Effects of Tetanus-Diphtheria Vaccine
Serious side effects are rare and include severe allergic reactions, severe shoulder pain, and muscle weakness.
Mild side effects include the following:
Soreness, pain, and redness at the injection site
Fever
Tiredness
Headache
Vomiting, nausea, diarrhea, or stomachache
If Guillain-Barré syndrome developed within 6 weeks after a tetanus vaccine was given, people should talk to their doctor about whether future vaccinations are advisable.
For more information about side effects, see the package inserts.
More Information
The following English-language resources may be useful. Please note that The Manual is not responsible for the content of these resources.
Centers for Disease Control and Prevention (CDC): Td (Tetanus, Diphtheria) vaccine information statement
European Centre for Disease Prevention and Control (ECDC): Diphtheria: Recommended vaccinations
