19 Tetanus

19.7 Expected responses and adverse events following immunisation (AEFI)

See also sections 5.7 and 14.7 for expected responses and adverse events following immunisation with Td, DTaP-IPV-HepB/Hib, DTaP-IPV and Tdap vaccines.

19.7.1 Expected responses

Tetanus toxoid combination vaccines have not been associated with any safety concerns. Sterile abscesses and persistent nodules at the injection site may develop if the injection is not given deeply enough into the muscle.9

Tdap has a safety profile similar to Td and both vaccines are generally well tolerated.10, 11

19.7.2 Adverse events following immunisationTop

Anaphylaxis was reported at a rate of 1.6 per million doses of Td in the US from 1991 to 1995. The 1994 US Institute of Medicine review of adverse events from tetanus vaccine concluded that the evidence supported a link with brachial plexus neuropathy at a rate of 0.5 to 1 per 100,000 doses within four weeks of immunisation.12 A large population-based study did not find a link with Guillain-Barré syndrome in an estimated 730,000 children who were of eligible age to receive DTwP in a population of 2.2 million children aged under 15 years, nor in adults who received tetanus toxoid-containing vaccines.13