Source: http://healthycanadians.gc.ca/publications/healthy-living-vie-saine/4-canadian-immunization-guide-canadien-immunisation/index-eng.php?page=22
Timestamp: 2016-12-11 07:56:48
Document Index: 647743657

Matched Legal Cases: ['art 3', 'art 5', 'art 1', 'art 5', 'art 1', 'art 2', 'art 5']

Updated: October 2014 Key Information
Post exposure/wound management: the need for tetanus toxoid-containing vaccine in wound management, with or without tetanus immune globulin depends on both the nature of the wound and the vaccination history
The black line within the graph representing the number of cases shows declining peaks following an initial report of less than 10 cases around 1957. The first peak of about 19 cases occurred at around 1961. After another brief decline to 9 cases by 1963, the next peak occurs at around 1964. After a few fluctuations, the number of cases declined to 3 by 1973 and further to a couple of cases by 1975. After rising to about 9 in 1978, for the first time the reported cases declined to zero in 1980. No reports are available for the years 1981 and 1982. However, by 1983, a transient upward trend is noticed, close to 9 by 1985. In 1994, 10 cases were reported. Between 1990 and 2010, the number of cases reported annually ranged from 1 to 10, with an average of 4 per year. Preparations Authorized for Use in Canada
HYPERTET® S/D (tetanus immune globulin (human) solvent/detergent treated), Grifols Therapeutics Inc. (TIg)
Adults who have not previously received a primary series (at least 3 doses) of tetanus toxoid-containing vaccine should receive one dose of Tdap-IPV vaccine followed by two doses of Td-IPV, vaccine. There is new evidence that a booster dose of Td vaccine may not be required every 10 years. Until a full review of the literature has been completed, a booster dose of Td vaccine is recommended every 10 years. Until a full review of the literature has been completed, a booster dose of Td vaccine is recommended every 10 years.
Residents of long-term care facilities should receive all routine immunizations appropriate for their age and risk factors, including tetanus toxoid-containing vaccine. Refer to Immunization of Persons/Residents in Health Care Institutions in Part 3 for additional general information.
The antibody response to tetanus boosters given to adults with HIV or humoral immune deficiencies is suboptimal. Tetanus immunity is lost in approximately 50% of patients undergoing chemotherapy for lymphoma or leukemia.
The most important goals of post-exposure prophylaxis are removing the source of toxin production and neutralizing any toxin which may have been released. The first goal is best achieved by timely, thorough wound cleaning. The second goal is achieved by providing or inducing high circulating concentrations of tetanus antibody, which inactivate the toxin. Effective neutralizing antibody concentrations at the time of the injury can only be achieved by prior completion of the tetanus toxoid-containing vaccine series or immediate administration of tetanus immune globulin (TIg).
Tetanus immune globulin (TIg) for prophylaxis
The recommended dose of HYPERTET® S/D (TIg) for adults and children 7 years of age and older is 250 units by deep intramuscular injection. In small children less than 7 years old, the routine prophylactic dose of HYPERTET® S/D is 4 units/kg. However, it may be advisable to administer the entire contents of the vial or syringe of HYPERTET® S/D (250 units) regardless of the child's size, since theoretically the same amount of toxin will be produced in the child's body by the infecting tetanus organism as it will in an adult's body.
Tetanus immune globulin (TIg) for treatment
For complete prescribing information, consult the product leaflet or information contained within Health Canada's authorized product monographs available through the Drug Product Database. Refer to Passive Immunization Part 5 for additional general information.
If infant immunization for hepatitis B is undertaken, DTaP-HB-IPV-Hib vaccine may be used as an alternative to separately administered hepatitis B and DTaP-IPV-Hib vaccines. DTaP-HB-IPV-Hib vaccine is authorized for use in children 6 weeks to 23 months of age and may be given to children aged 24 months to less than 7 years, if necessary. DTaP-HB-IPV-Hib vaccine may be given at 2, 4, 6 and 12 to 23 months of age but the fourth dose is unlikely to provide significant additional hepatitis B
Tetanus toxoid-containing preparations should be stored in a refrigerator at +2°C to +8°C and must not be frozen. Refer to Storage and Handling of Immunizing Agents in Part 1 for additional general information. Refer to Passive Immunization in Part 5 for information regarding immune globulin storage.
Serious adverse events are rare following immunization with tetanus toxoid-containing vaccines and, in most cases, data are insufficient to determine a causal association. Severe systemic
reactions such as generalized urticaria, anaphylaxis, or neurologic complications have been reported rarely.
Tetanus toxoid-containing vaccines are contraindicated in persons with a history of anaphylaxis after previous administration of the vaccine and in persons with proven immediate or anaphylactic hypersensitivity to any component of the vaccine or its container. Refer to Contents of Immunizing Agents Available for use in Canada in Part 1 for lists of all vaccines and passive immunizing agents available for use in Canada and their contents. For the tetanus toxoid-containing vaccines, potential allergens include:
BOOSTRIX®: latex in plunger stopper of pre-filled syringe
There are no currently known potential allergens in ADACEL®or Td ADSORBED vaccines.
Refer to General Contraindications and Precautions in Part 2 and Passive Immunization in Part 5 for additional general information.