Tetanus
The Disease
Tetanus has never been a big killer in the UK. It is now very rare, with less than 10 cases a year reported. However, it is am extremely dangerous disease, which kills up to 1 in 5 people who get the disease, even with the best modern treatment.
Unlike other diseases against which we immunise, tetanus cannot be caught from someone else. Tetanus is caused by the toxin (or poison) of the spores of the Clostridium tetani bacterium. These spores are found all over the world in soil and manure. If they infect a wound, the toxin can cause painful muscle cramps, ‘lockjaw’, and, if severe, spasms of the whole body which can lead to death.
The Vaccine
The 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.1 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. There have been surprisingly few proper trials to test the vaccine’s effectiveness, but it probably works well in most people. It s 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.
Tetanus immunisation often causes 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 and polio 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.2
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.
The choices
| Infanrix | |
| Type of vaccine: | Triple DTaP vaccine |
| Manufacturer: | GlaxoSmithKline |
| Protects against: | Diphtheria Tetanus Whooping cough |
| Active ingredients: | 30IU diphtheria toxoid 40IU tetanus toxoid 25µg pertussis toxin 25µg filamentous haemagglutinin 8µg pertactin |
| Mercury content: | Nil |
| Aluminium content: | 0.5mg |
| Other ingredients: | 2-phenoxylethanol (preservative) |
| Primary course: | 3 doses, usually given in first year of life |
| Boosters: | Single dose from 3 years of age |
| Daptacel | |
| Type of vaccine: | Triple DTaP vaccine |
| Manufacturer: | Sanofi Pasteur |
| Protects against: | Diphtheria Tetanus Whooping cough |
| Active ingredients: | 15Lf diphtheria toxoid 5Lf tetanus toxoid 10µg pertussis toxin 5µg filamentous haemagglutinin 3µg pertactin 5µg fimbriae types 2 and 3 |
| Mercury content: | Nil |
| Aluminium content: | 0.33mg |
| Other ingredients: | ‰¤5µg formaldehyde <50ng gluteraldehyde 3.3mg 2-phenoxylethanol |
| Primary course: | 3 doses, usually given in first year of life |
| Boosters: | Single dose during second year of life Single dose at 4-6 years of age |
| Revaxis | |
| Type of vaccine: | Triple dT-IPV booster vaccine |
| Manufacturer: | Sanofi Pasteur MSD |
| Protects against: | Diphtheria Tetanus Polio |
| Active ingredients: | 2U diphtheria toxoid 20IU tetanus toxoid 40 units type 1 polio 8 units type 2 polio 32 units type 3 polio |
| Mercury content: | Nil |
| Aluminium content: | 0.35mg |
| Other ingredients: | formaldehyde 2-phenoxylethanol neomycin streptomycin polymyxin B |
| Primary course: | This vaccine is not suitable for use for primary immunisation |
| Boosters: | Single dose from the age of 6 years |
D or d = diphtheria
T = tetanus
aP = acellular pertussis
IPV = inactivated polio vaccine
The supply of single and small combination vaccines may change over time. At BabyJabs we are on the constant lookout for safe and effective vaccines to offer your child. We may obtain different vaccines to those listed above. We will only offer you alternative vaccines if we are completely confident of their safety and efficacy.
Go back to vaccines at a glance
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1 Boyd J. Tetanus Immunization. Proceedings of a Symposium on Immunization in Childhood. Cannon DA. E&S Livingstone 1960.
2 Quast U. Hennessen W. Widmark RM. Mono- and Polyneuritis after Tetanus Vaccination (1970-1977). International Symposium on Immunization: Benefit Versus Risk Factors, Brussels 1978. Developments in Biological Standardization 1979; 43: 25-32.
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BabyJabs - The Children's Immunisation Service that enables you to make an informed choice of vaccines for your child
BabyJabs - The Children's Immunisation Service that enables you to make an informed choice of vaccines for your child
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Copyright 2009 © BabyJabs Ltd