Tetanus VaccineThe tetanus vaccine is a ‘toxoid’ that stimulates the body to make antibodies against the poisonous tetanus toxin. It was first used extensively amongst servicemen in the Second World War. The British and American armies had remarkably few cases of tetanus, but the disease was much more common in the Germans who had not been immunised. This ‘trial’ constituted the main evidence for the effectiveness of the tetanus vaccine. Soon after the war it was recommended as part of the newly evolving childhood immunisation schedule and in 1961 was incorporated into the DTP triple vaccine along with whooping cough and diphtheria.
EffectivenessThere have been surprisingly few proper trials to test the vaccine’s effectiveness, but it probably works well in most people. It is initially given as a course of three injections, and two further boosters (usually given at 4 years and in the mid-teens) provide long-term protection.
Side effectsTetanus immunisation can cause pain, redness and swelling at the site of the injection; the more injections any one person receives, the more common these local, but uncomfortable, side effects become. This is one reason why the Department of Health, quite rightly, advises against indiscriminate boosters of the vaccine. Because tetanus immunisation has always been given to children in combination with other vaccines (diphtheria and whooping cough initially, and now Hib, polio and hepatitis B as well), it is all but impossible to single out side effects due entirely to the tetanus component. Fever, drowsiness, fretfulness, vomiting, and going off feeds can all occur in young children given tetanus-containing vaccines. Serious side effects caused by tetanus toxoid (vaccine) alone are probably very rare. Neuritis, an inflammation of one or more nerves causing a partial paralysis or lack of feeling that is occasionally permanent is a very rare complication.
Guillain-Barré syndrome (GBS), a disorder of the nerves causing, usually temporary, paralysis can probably be caused by the vaccine. There are reports of arthritis, and even temporary coma occurring after a tetanus vaccine, but these are extremely rare. It is safe to say that serious side effects after tetanus immunisation are very unusual.
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