Td Vaccine Dosing
The dose of Td (tetanus-diphtheria) vaccine is 0.5 mL administered intramuscularly, preferably into the deltoid muscle. 1
Standard Administration Details
- Volume and route: Each dose consists of exactly 0.5 mL given via intramuscular injection 1, 2
- Injection site: The deltoid muscle is the preferred anatomical location for adolescents and adults 1
- Separate syringes required: When multiple vaccines are indicated during the same visit, each must be administered using a separate syringe at different anatomic sites 1
Primary Series Dosing Schedule
For adults who have never completed a primary tetanus vaccination series, the schedule is:
- Dose 1: 0.5 mL Tdap (preferred over Td to provide pertussis protection) 3
- Dose 2: 0.5 mL Td or Tdap administered ≥4 weeks after the first dose 3
- Dose 3: 0.5 mL Td or Tdap given 6-12 months after the second dose 3
Booster Dosing
- Routine boosters: 0.5 mL of Td every 10 years after completing the primary series to maintain protection against tetanus and diphtheria 4, 5
- Wound management exception: For contaminated or tetanus-prone wounds, administer 0.5 mL if >5 years have elapsed since the last tetanus-containing vaccine 4, 5
Important Clinical Considerations
Tdap vs. Td distinction: While the question asks specifically about Td, current guidelines recommend that adults who have never received Tdap should receive one 0.5 mL dose of Tdap instead of Td for their next booster, regardless of the interval since their last tetanus vaccine 4, 3. After receiving Tdap once, subsequent decennial boosters use 0.5 mL of Td 4.
No dose adjustment needed: The 0.5 mL dose remains constant across all age groups from adolescence through elderly adults (≥65 years), with no reduction or increase required 1, 4.
Critical Pitfalls to Avoid
- Do not administer more frequently than every 10 years for routine immunization, as this increases the risk of Arthus reactions (severe local hypersensitivity) 4, 3
- Do not use DTaP in persons ≥7 years of age—always use Td or Tdap instead, as DTaP is formulated for children and not licensed for older individuals 1, 3
- Do not restart the series if doses are delayed—simply continue from where the patient left off, as immunity does not require restarting 4