Other drug names:	A-Am  An-Az  B  C-Ch  Ci-Cz  D-Dh  Di-Dz  E  F  G  H  I-J  K-L  M-Mh  Mi-Mz  N-Nh  Ni-Nz  O  P-Pl  Pm-Pz  Q-R  S-Sn  So-Sz  T-To  Tp-Tz  U-V  W-Z  0-9

A commonly used name for diphtheria and tetanus toxoids for pediatric use is DT.A commonly used name for tetanus and diphtheria toxoids for adult use is Td.

• Immunizing agent, active

Diphtheria and Tetanus Toxoids (also known as DT and Td) is a combination immunizing agent given by injection to prevent diphtheria and tetanus.

Diphtheria is a serious illness that can cause breathing difficulties, heart problems, nerve damage, pneumonia, and possibly death. The risk of serious complications and death is greatest in very young children and in the elderly.

Tetanus (also known as lockjaw) is a serious illness that causes convulsions (seizures) and severe muscle spasms that can be strong enough to cause bone fractures of the spine. Tetanus causes death in 30 to 40 percent of cases.

Immunization with diphtheria and tetanus toxoids for pediatric use (DT) is recommended for infants and children from 6 weeks of age (8 weeks in Canada) up until their 7th birthday.

Children 7 years of age and older and adults should be immunized with tetanus and diphtheria toxoids for adult use (Td). In addition, these children and adults should receive booster doses of Td every 10 years for the rest of their lives.

Diphtheria and tetanus are serious diseases that can cause life-threatening illnesses. Although some serious side effects can occur after a dose of DT or Td, these are rare. The chance of your child catching one of these diseases and being permanently injured or dying as a result is much greater than the chance of your child getting a serious side effect from the DT or Td vaccine.

DT and Td are available in the following dosage form:

Parenteral
• Injection (U.S. and Canada)

In deciding to use a vaccine, the risks of using the vaccine must be weighed against the good it will do. This is a decision you and your doctor will make. For DT and Td, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to diphtheria toxoid, tetanus toxoid, DT, or Td. Also tell your health care professional if you are allergic to any other substances, such as preservatives.

Pregnancy—This vaccine has not been shown to cause birth defects or other problems in humans. Immunization of a pregnant woman can prevent her newborn baby from getting tetanus at birth.

Breast-feeding—This vaccine has not been shown to cause problems in nursing babies.

Children—For infants up to 6 weeks of age, use of DT or Td is not recommended.

For infants and children 6 weeks up to 7 years of age, Td is not recommended. DT is used instead.

For children 7 years of age and older, DT is not recommended. Td is used instead.

Older adults—DT is not recommended. Td is used instead. Td is not expected to cause different side effects or problems in older people than it does in younger adults. However, Td may be slightly less effective in older people than in younger adults.

Other medical problems—The presence of other medical problems may affect the use of DT or Td. Make sure you tell your doctor if you have any other medical problems, especially:

• Fever or
• Infection or illness (severe)—Use of DT or Td may make the condition worse or may increase the chance of side effects

Dosing—

The doses of DT and Td will be different for different patients. The following information includes only the average doses of DT and Td.

For DT
• For injection dosage form:
  • For prevention of diphtheria and tetanus:
    • Children up to 6 weeks of age—Use is not recommended.
    • Children 6 weeks to 1 year of age—One dose is given every four to eight weeks for a total of three doses. A fourth dose is given six to twelve months after the third dose. A booster (fifth) dose is given when the child is four to six years of age. The booster (fifth) dose is given only if the fourth dose was given before the child's fourth birthday. The doses are injected into a muscle.
    • Children 1 to 7 years of age—One dose is given at the first visit to the doctor, followed by a second dose four to eight weeks later. A third dose is given six to twelve months after the second dose. A booster (fourth) dose is given when the child is four to six years of age. The booster (fourth dose) is given only if the third dose was given before the child's fourth birthday. The doses are injected into a muscle.
    • Adults and children 7 years of age and over—Use is not recommended. Td should be used instead.

For Td
• For injection dosage form:
  • For prevention of diphtheria and tetanus:
    • Children up to 7 years of age—Use is not recommended. DT should be used instead.
    • Adults and children 7 years of age and over—One dose is given at the first visit to the doctor, followed by a second dose four to eight weeks later. A third dose is given six to twelve months after the second dose. You should receive a booster dose every ten years. In addition, if you get a wound that is unclean or hard to clean, you may need an emergency booster injection if it has been more than five years since your last booster dose. The doses are injected into a muscle.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. It is very important that you tell your doctor about any side effect that occurs after a dose of DT or Td, even if the side effect has gone away without treatment. Some types of side effects may mean that you should not receive any more doses of DT or Td.

Get emergency help immediately if any of the following side effects occur:

• Rare--Symptoms of allergic reaction
  • Difficulty in breathing or swallowing;  hives;  itching, especially of feet or hands;  reddening of skin, especially around ears;  swelling of eyes, face, or inside of nose;  unusual tiredness or weakness (sudden and severe) 
  
  

Check with your doctor as soon as possible if any of the following side effects occur:

• Rare
  • Confusion;  convulsions (seizures);  excessive sleepiness;  fever over 39.4 °C (103 °F);  headache or vomiting (severe or continuing);  hives;  itching;  joint aches or pain;  skin rash;  swelling, blistering, pain, or other severe reaction at the place of injection (generally starts within 2 to 8 hours after the injection);  unusual irritability 
  
  

Other side effects may occur that usually do not need medical attention. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common--For DT and Td
  • Redness or hard lump at the place of injection (this may last for a few days; however, less often, the hard lump may last for a few weeks) 
  
  

• More common--For DT only
  • Fever under 39.4 °C (103 °F);  swelling, pain, or tenderness at the place of injection (this may last for a few days) 
  
  

• Less common--For DT and Td
  • Dent or indentation at the place of injection 
  
  

• Less common--For DT only
  • Crying (continuing);  drowsiness;  fretfulness;  loss of appetite;  vomiting 
  
  

• Less common--For Td only
  • Chills ;  fast heartbeat;  fever under 39.4 °C (103 °F);  general feeling of discomfort or illness;  headache;  muscle aches;  swelling of glands in armpit;  unusual tiredness or weakness 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Developed: 04/26/1995

Revised: 07/09/2003