AdultPediatricDosage Forms & Strengths Lf (flocculation units) diphtheria/tetanus toxoid injection, suspension (Td) (2Lf/2Lf)/0.5mL (TDVAX) (2Lf/5Lf)/0.5mL (Tenivac) Primary Immunization Adults who did not receive primary vaccination series Give first dose as Tdap, THEN Give second dose as Td 0.5 mL IM at least 4 weeks after the first dose, THEN Give third dose as Td 0.5 mL IM 6-12 months later Routine Booster Immunization 0.5 mL (Td or Tdap) every 10 years (patients that have completed primary immunization) Diphtheria Prophylaxis for Case Contacts Indicated for postexposure prophylaxis in persons who have not completed primary vaccination, whose vaccination status is unknown, or who have not been vaccinated with diphtheria toxoid within the previous 5 yr Administer primary series using Td to catch up with vaccinations Tetanus Prophylaxis in Wound Management For active tetanus immunization in wound management, a preparation containing tetanus and diphtheria toxoids (Td) is preferred instead of single-antigen tetanus toxoid to enhance diphtheria protection The need for active immunization with a tetanus toxoid-containing preparation, with or without passive immunization with tetanus immune globulin (TIG) depends on both the condition of the wound and the patient’s vaccination history Clean minor wounds Unknown or <3 tetanus doses: Administer Td 3 or more tetanus doses (if <10 years since last dose): No dose needed 3 or more tetanus doses (>10 years since last dose): Administer Td All other wounds Unknown or <3 tetanus doses: Administer Td and TIG 3 or more tetanus doses (if <5 yr since last dose): No dose needed 3 or more tetanus doses (>5 yr since last dose): Administer Td; if patient has history of Arhus-type reaction, administer only if at least 10 yr since last tetanus-containing immunization Dosage Forms & Strengths Lf (flocculation units) diphtheria/tetanus toxoid injection, suspension (Td) (2Lf/2Lf)/0.5mL (TDVAX) (2Lf/5Lf)/0.5mL (Tenivac) injection, suspension (DT) for children younger than 7 years (25Lf/5Lf)/0.5mL Primary Immunization For individuals who have not been immunized <7 years DT 5-dose series DT may be used if pertussis component contraindicated; DTaP preferred for primary immunization in children aged <7 years Three doses: 0.5 mL IM at 2, 4, and 6 months of age; may administer as early as 6 weeks of age and repeated every 4-8 weeks Fourth dose: At least 6 months must elapse after third dose; may give as early as 12 months of age if 6 months have passed since the third dose Fifth dose: 4-6 years of age before starting school or kindergarten; may omit this dose if fourth dose given >4 years of age ≥7 years Unimmunized individuals Give first dose as Tdap, THEN Give second dose as Td 0.5 mL IM at least 4 weeks after the first dose, THEN Give third dose as Td 0.5 mL IM 6 months later Routine Booster Immunization 0.5 mLIM every 10 years (patients that have completed primary immunization) Diphtheria Prophylaxis for Case Contacts Indicated for postexposure prophylaxis in persons aged ≥7 yr who have not completed primary vaccination, whose vaccination status is unknown, or who have not been vaccinated with diphtheria toxoid within the previous 5 yr Administer primary series using Td to catch up with vaccinations Tetanus Prophylaxis in Wound Management For active tetanus immunization in wound management of patients aged ≥7 yr, a preparation containing tetanus and diphtheria toxoids (Td) is preferred instead of single-antigen tetanus toxoid to enhance diphtheria protection The need for active immunization with a tetanus toxoid-containing preparation, with or without passive immunization with tetanus immune globulin (TIG) depends on both the condition of the wound and the patient’s vaccination history Clean minor wounds Unknown or <3 tetanus doses: Administer Td 3 or more tetanus doses (if <10 years since last dose): No dose needed 3 or more tetanus doses (>10 years since last dose): Administer Td All other wounds Unknown or <3 tetanus doses: Administer Td and TIG 3 or more tetanus doses (if <5 years since last dose): No dose needed 3 or more tetanus doses (>5 years since last dose): Administer Td Interaction CheckerEnter a drug name and diphtheria & tetanus toxoidsNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (1)belimumabbelimumab decreases effects of diphtheria & tetanus toxoids by immunosuppressive effects; risk of infection. Contraindicated. Do not administer live vaccines 30 days before or concurrently with belimumab.Serious - Use Alternative (39)adalimumabadalimumab decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.alefaceptalefacept decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.anakinraanakinra decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.antithymocyte globulin equineantithymocyte globulin equine decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.antithymocyte globulin rabbitantithymocyte globulin rabbit decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.azathioprineazathioprine decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.basiliximabbasiliximab decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.budesonidebudesonide decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.canakinumabcanakinumab decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.cortisonecortisone decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.cyclosporinecyclosporine decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.deflazacortdeflazacort decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.dexamethasonedexamethasone decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.elivaldogene autotemcelelivaldogene autotemcel, diphtheria & tetanus toxoids. Either decreases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: The safety and effectiveness of vaccination during or following elivaldogene autotemcel treatment have not been studied. Vaccination is not recommended during the 6 weeks preceding myeloablative conditioning, and until hematological recovery following elivaldogene autotemcel treatment. Where feasible, administer childhood vaccinations before myeloablative conditioning. .etanerceptetanercept decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.everolimuseverolimus decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.fludrocortisonefludrocortisone decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.glatiramerglatiramer decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.golimumabgolimumab decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hydrocortisonehydrocortisone decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.hydroxychloroquine sulfatehydroxychloroquine sulfate decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.infliximabinfliximab decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.ixekizumabixekizumab decreases effects of diphtheria & tetanus toxoids by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating ixekizumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with ixekizumab may not elicit an immune response sufficient to prevent disease.leflunomideleflunomide decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.methylprednisolonemethylprednisolone decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.muromonab CD3muromonab CD3 decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.mycophenolatemycophenolate decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.prednisoloneprednisolone decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.prednisoneprednisone decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.rilonaceptrilonacept decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.secukinumabsecukinumab decreases effects of diphtheria & tetanus toxoids by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.siponimodsiponimod decreases effects of diphtheria & tetanus toxoids by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Pause vaccinations beginning 1 week before initiating siponimod and for 4 weeks after stopping treatment. Coadministration with live attenuated vaccines may increase infection risk.sirolimussirolimus decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tacrolimustacrolimus decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.temsirolimustemsirolimus decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.teplizumabteplizumab decreases effects of diphtheria & tetanus toxoids by Other (see comment). Avoid or Use Alternate Drug. Comment: Administer all age-appropriate vaccinations before starting teplizumab. Inactivated or mRNA vaccines are not recommended within 2 weeks before teplizumab treatment, during treatment, or 6 weeks after completion of treatment.tocilizumabtocilizumab decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.triamcinolone acetonide injectable suspensiontriamcinolone acetonide injectable suspension decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.ustekinumabustekinumab decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Prior initiating therapy, patients should receive all age-appropriate immunizations as recommended by current guidelines. Immunosuppressants also increase risk of infection with concomitant live vaccines.Monitor Closely (10)belataceptbelatacept decreases effects of diphtheria & tetanus toxoids by Other (see comment). Use Caution/Monitor. Comment: The use of live vaccines should be avoided during treatment with belatacept. Inform patients that vaccinations may be less effective while they are being treated with belatacept.certolizumab pegolcertolizumab pegol decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Use Caution/Monitor.delandistrogene moxeparvovecdelandistrogene moxeparvovec, diphtheria & tetanus toxoids. Other (see comment). Use Caution/Monitor. Comment: Consider patient vaccination status before initiating corticosteroid regimen required before delandistrogene moxeparvovec administration. If possible, ensure patients are current with all immunizations according to immunization guidelines. Complete vaccinations at least 4 weeks before starting corticosteroid regimen. High-dose or long-term corticosteroids may decrease immungenicity of vaccines.dengue vaccinedengue vaccine, diphtheria & tetanus toxoids. unspecified interaction mechanism. Use Caution/Monitor. Data are not available to establish safety and immunogenicity of coadministration of dengue vaccine with recommended adolescent vaccines.ifosfamideifosfamide decreases effects of diphtheria & tetanus toxoids by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .melphalanmelphalan decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .mercaptopurinemercaptopurine decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressants also increase risk of infection with concomitant live vaccines.methotrexatemethotrexate decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Use Caution/Monitor. Concomitant administration of methotrexate can decrease the immunological response of vaccines.oxaliplatinoxaliplatin decreases effects of diphtheria & tetanus toxoids by passive renal tubular reabsorption due to increased pH. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the