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The CDC issued new guidance for doctors about administering tetanus shots in advance of an upcoming shortage. SolStock/Getty Images
  • The CDC is urging healthcare professionals to conserve their supply of the Td vaccine, a type of tetanus shot, in advance of an upcoming shortage.
  • Doctors should administer the Tdap vaccine instead of the Td vaccine when possible to protect against tetanus.
  • Experts say the widely available Tdap vaccine is the preferred tetanus shot since it also protects against whooping cough.

If you’ve ever been to the emergency room to treat a serious wound, you probably received a tetanus shot.

As the most commonly administered vaccine in the ER, tetanus shots are used to protect against tetanus, an infection caused by Clostridium tetani bacteria. However, health officials say a common type of tetanus vaccine may soon be in short supply.

The Centers for Disease Control and Prevention (CDC) is advising healthcare professionals to preserve the Td vaccine, also known as TdVax, which protects against tetanus and diphtheria infections.

The new guidance follows a recent announcement from the vaccine’s manufacturer, MassBiologics, that it would discontinue production of the shot. Grifols, the sole supplier of TdVax, anticipates running out of the vaccine by June 2024, the CDC shared with its vaccine advisory panel on Wednesday.

The CDC reports that Sanofi, the only other manufacturer of a Td vaccine licensed and approved for use in the United States, is ramping up its supply of the shot.

“Temporary ordering controls are in place in the public and private sectors to help manage the gap in supply,” a spokesperson for the CDC told Healthline. The Tdap vaccine is available for use without supply constraints at this time, the spokesperson said.

The CDC recommends doctors administer the Tdap vaccine instead of Td. The Tdap vaccine also offers protection against pertussis or whooping cough.

In most cases, Tdap and Td shots are used interchangeably among older children and adults. Younger children under 7 receive the DTap vaccine. There’s a small number of people with contraindications to pertussis-containing vaccines who should continue to receive the Td shot.

“Based on the rarity of developing a contraindication to pertussis-containing vaccines, the temporarily constrained supply of Td vaccine is not anticipated to prevent providers from utilizing Td vaccine for these children in the VFC program,” the CDC told its vaccine panel.

Dr. William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center in Nashville, told Healthline that one reason for the shortage of the Td shot is there’s no longer a market for it. The Tdap vaccine, he said, is the preferred tetanus vaccine.

“I’m a little concerned about the language in talking about shortage because there is no shortage in Tdap,” Schaffner said. “From a public health point of view, there’s no real concern because there’s plenty of Tdap, [we] just have to persuade the small number of providers that are still using Td to use Tdap instead.”

Indeed, the CDC confirmed for Healthline that based on available data, most people who received a tetanus shot in the past 10 years received the Tdap vaccine.

Tdap is the preferred tetanus shot because it contains [acellular] pertussis, which provides protection against whooping cough.

“That’s an immunization where the protection begins to wane fairly substantially,” he said. “That’s why it’s preferred to be used in these circumstances because you’ll also get protection against whooping cough, and we want to reduce that as much as possible.”

While infants are most at risk for severe illness and death from whooping cough, this disease can impact individuals of all ages, Schaffner said, regardless of whether they are unvaccinated or have waning immunity.

“It’s a historical disease,” he said. “That’s why we immunize widely. That’s why we vaccinate children as early as possible, starting at 2 months, and why it is recommended that everyone who has contact with a newborn should be up to date with their Tdap immunizations because adults and older siblings and other children can bring the bacteria Bordetella pertussis to the infant.”

Dr. Monica Gandhi, MPH, professor of medicine at the University of California, San Francisco, echoed the Tdap vaccine’s protective benefits against whooping cough but noted it may not be as cost-effective for healthcare professionals compared to the Td vaccine.

While the cost of the Tdap vaccine is slightly higher, both vaccines are typically covered by insurance.

“The discontinuation of the vaccine that protects for both tetanus and diphtheria called Td is disappointing because it means that clinics will now have to stock the more expensive Tdap vaccine,” Gandhi told Healthline.

“I suspect that this will not cut down on vaccination rates, but will mean that the more expensive vaccine formulation for three different pathogens will be stocked by clinics,” she said.

Tetanus is a bacterial infection affecting the nervous system and muscles, particularly the neck and jaw. But with the help of vaccines, tetanus has essentially been eradicated.

The CDC recommends tetanus shots for all individuals after the childhood vaccine series every 10 years since these vaccinations do not provide lifelong immunity.

There are three types of tetanus shots used in the U.S. to protect against tetanus and other infectious diseases, but only pertussis-containing vaccines protect against whooping cough:

  • DTap vaccines: diphtheria, tetanus, and pertussis
  • Tdap: tetanus, diphtheria, and pertussis
  • Td vaccines: tetanus and diphtheria

Infants and children under 7 receive DTap shots whereas older children and adults receive Tdap and Td.

The CDC confirmed the Tdap vaccine is an acceptable alternative to the Td vaccine, including when a tetanus booster is indicated for wound management.

Common side effects of a tetanus shot include soreness, redness, or swelling at the injection site. Some individuals may experience a rash.

In rare cases, tetanus shots containing pertussis may cause a severe allergic reaction, such as anaphylaxis or encephalopathy. People with a contraindication to receiving pertussis-containing vaccines should continue to receive the Td vaccine only, the CDC told Healthline.

Each tetanus shot works with different effectiveness, Schaffner explained, but all are effective at protecting against tetanus.

Schaffner, who spoke with Healthline during a two-day meeting with the CDC’s Advisory Committee on Immunization Practices, said tetanus shots have been “brilliantly successful” at eliminating tetanus and diphtheria in the U.S.

“Vaccines have the capacity to eliminate diseases almost completely,” he said. “With tetanus, it’s extraordinary because the bacteria that causes tetanus hasn’t disappeared — it’s in the soil all around us, it’s environmentally constant. So what we’ve done is protected our entire population should they encounter this bacteria,” Schaffner said.

The CDC has issued new guidance for healthcare professionals about administering the tetanus shot in advance of an upcoming shortage.

The federal agency says doctors should use the Tdap vaccine instead of the Td vaccine, reserving the latter for high risk patients allergic to pertussis only.

Tetanus shots are recommended every 10 years to protect against serious bacterial infection and whooping cough.

If you can’t remember the last time you had a tetanus shot, it may be time to call your doctor.