Tetanus - the Vaccine
Tetanus immunisation was first provided in the UK in 1938, initially for the Armed Forces, but later given to all children from the 1950s as part of the DPT vaccination programme.
Tetanus vaccine is given only in combination with Diphtheria, because it gives an improved antibody response when the two are mixed together in the vaccine: Since September 2004, the following combination vaccines have been available for children:
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PEDIACEL ® (DTaP/IPV/Hib - this is the new 5:1 vaccine which includes high dose Diphtheria, Tetanus and Pertussin; plus injectable Polio and Hib) given at 2/3/4 months
INFANRIX ® (DTaP/IPV) pre-school age 4-5 years
REPEVAX ® (dTaP/IPV - which includes low dose Diphtheria, Tetanus and Pertussin; and injectable Polio) pre-school age 4-5 years
REVAXIS ® (dT/IPV - which includes low dose Diphtheria and Tetanus; and injectable Polio) given at age 14-15 years
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DIFTAVAX ® (Td) available but not recommended by government for routine use in babies and children
The Tetanus vaccine is made from a purified cell-free toxin extracted from a strain of C tetani. This is treated with formaldehyde to convert it to Tetanus toxin. Aluminium phosphate or aluminium hydroxide is added as a base. Also added in trace amounts are the antibiotics neomycin, streptomycin and polymyxin B. From September 2004, the vaccine is free of thiomersal (mercury). Other additives include:
- medium 199 - which contains polysorbate 80, an emulsifying (thickening) agent derived from Sorbitol polyribosylribitol phosphate (an artificial sweetener)
- 2-phenoxyethanol (phenol) - a preservative
Adverse reactions reported by Dept of Health and Aventis Pasteur ® include pain, swelling or redness at the injection site; lethargy, malaise and urticaria (rashes); high fever, convulsions and seizures; high-pitched screaming for more than 3 hours; episodes of pallor, cyanosis and limpness; nerve damage to the inner ear; peripheral neuropathy, Guillain-Barré syndrome and paralysis; encephalopathy, encephalitis and (rarely) anaphylaxis. Also arthralgia (joint pain), myalgia, hypotension, lymphadenopathy (swelling of lymph nodes) and oedema. The tetanus booster can cause T-lymphocyte blood cells (needed to fight infection) to plunge temporarily below normal levels (a response also seen in AIDS cases). This is why it is inadvisable to vaccinate a baby who has a cold or fever. Adults who have received the normal five doses of tetanus as a child do not need to receive more. It has proved to be unnecessary, and can cause considerable local skin reaction. If you decide to vaccinate your child against tetanus, there is no need until the child is old enough to walk and play on its own. At this age, the vaccine is less likely to cause complications, since the immune system has had time to develop. If you decide to avoid the tetanus vaccination completely for your child, you can give TIG (tetanus immune globulin), but only if and when the child receives a serious wound or deep puncture. TIG contains tetanus antibodies which will directly attack tetanus bacilli in circulating blood. This helps to prevent the multiplication of the bacteria and the subsequent development of infection, if used within a few days of the injury. However, TIG will not give lasting immunity to tetanus and is given in hospitals irrespective of previous immunisation status.
The homeopathic prophylaxis is CLOSTRIDIUM TETANI 30c. Take this once a week while trekking, mountaineering, exploring.