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Tetanus vaccine adverse reactions

Adverse reactions to tetanus toxoid.

David D, et al. [Tetanus vaccination: adverse effects in diverse vaccination sites and mode of administration]. Schweiz Med Wochenschr. 1971 Jul 24;101(29):1055-6. German. No abstract available.PMID: 5569014; UI: 71284876.

Relihan M. [See Related Articles] Reactions to tetanus toxoid. J Ir Med Assoc. 1969 Dec;62(390):430-4. No abstract available.PMID: 5359656; UI: 70061241.

Mandal GS, et al. [See Related Articles] Adverse reactions following tetanus toxoid injection. J Indian Med Assoc. 1980 Jan 16;74(2):35-7. No abstract available.PMID: 7381219; UI: 80205496.

Bensasson M, et al. [See Related Articles] [A case of algodystrophic syndrome of the upper limb following tetanus vaccination]. Sem Hop. 1977 Oct 23;53(36):1965-6. French. No abstract available.PMID: 208165; UI: 78204280.

Bolukbasi O, et al.    Acute disseminated encephalomyelitis associated with tetanus vaccination. Eur Neurol. 1999;41(4):231-2. No abstract available.PMID: 10343155; UI: 99276501.   

Bilyk MA, et al. [See Related Articles] [Anaphylactic reaction following subcutaneous administration of tetanus anatoxin]. Klin Med (Mosk). 1978 Sep;56(9):137-8. Russian. No abstract available.PMID: 703231; UI: 79030708.

Crone, NE(1992); Reder, AT; Severe tetanus in immunized patients with high anti-tetanus titers; Neurology 1992; 42:761-764;
Article abstract: Severe (grade III) tetanus occurred in three immunized patients who had high serum levels of anti-tetanus antibody. The disease was fatal in one patient. One patient had been hyperimmunized to produce commercial tetanus immune globulin. Two patients had received immunizations one year before presentation. Anti-tetanus antibody titers on admission were 25 IU/ml to 0.15 IU/ml by hemagglutination and ELISA assays; greater than 0.01 IU/ml is considered protective. Even though one patient had seemingly adequate anti-tetanus titers by in vitro measurement 0.20 IU in vivo mouse protection bioassays showed a titer less than 0.01 IU/ml, implying that there may have been a hole in her immune repertoire to tetanus neurotoxin but not to toxoid. This is the first report of grade III tetanus with protective levels of antibody in the United States. The diagnosis of tetanus, nevertheless, should not be discarded solely on the basis of seemingly protective anti-tetanus titers.

Dieckhofer K, et al. [See Related Articles] [Neurologic disorders following tetanus vaccination. A case report]. Med Welt. 1978 Nov 3;29(44):1710-2. German. No abstract available.PMID: 713792; UI: 79052412.

Drago F, et al. [See Related Articles] Generalized morphoea after antitetanus vaccination. Clin Exp Dermatol. 1998 May;23(3):142. No abstract available.PMID: 9861750; UI: 99078743.

Hansson H, et al. [See Related Articles] Cutaneous reactions to merthiolate and their relationship to vaccination with tetanus toxoid. Acta Allergol. 1971 Apr;26(2):150-6. No abstract available.PMID: 5109839; UI: 72001961.

Fenichel GM. [See Related Articles] Neurologic complications of tetanus toxoid. Arch Neurol. 1983 Jun;40(6):390. No abstract available.PMID: 6847451; UI: 83203564.

Farbaky M. [See Related Articles] [Neurological complication after vaccination by tetanic anatoxin]. Cesk Epidemiol Mikrobiol Imunol. 1981 Jan;30(1):10-2. Slovak. No abstract available.PMID: 6451302; UI: 81135899.

Hurwitz EL, Morgenstern H. Effects of diphteria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States. J Manipulative Physiol Ther 2000;23: 1-10.
A new study in the Journal of Manipulative and Physiological Therapeutics¹ supports the findings of three previous studies that children who receive diphteria-tetanus-pertussis (DTP) or tetanus vaccines are more likely to have a "history of asthma" or other "allergy-related respiratory symptoms." The study reviewed data from the Third National Health and Nutrition Examination Survey, which was conducted by the National Center for Health Statistics from 1988 to 1994. The survey data included interviews (by proxy with parents) of 13,944 infants, children and adolescents (2 months through 16 years old). http://www.chiroweb.com/archives/18/07/05.html Kittler FJ, et al. [See Related Articles] Reactions to tetanus toxoid. South Med J. 1966 Feb;59(2):149-53. No abstract available.PMID: 5903351; UI: 66078441.

Lleonart-Bellfill R, et al. [See Related Articles] Tetanus toxoid anaphylaxis. DICP. 1991 Jul-Aug;25(7-8):870. No abstract available.PMID: 1949950; UI: 92056930.

Pantazopoulos, PE, "Perceptive Deafness Following Prophylactic use of Tetanus anittoxin", Laryngoscope, Dec 1965, 75:1832-1836.

Pataky L. [See Related Articles] [Late vaccination complications in the prevention of tetanus and rabies]. Z Gesamte Hyg. 1977 Dec;23(12):917-8. German. No abstract available.PMID: 607649; UI: 78119575.

Paradiso G, et al. [See Related Articles] [Multifocal demyelinating neuropathy after tetanus vaccine]. Medicina (B Aires). 1990;50(1):52-4. Spanish. PMID: 2292912; UI: 91155723.

Pollard, JD (1978); Selby, G; Relapsing Neuropathy due to tetanus toxoid; Journal of the Neurological Sciences, 1978, 37: 113-125

Summary: A unique case history is presented of a 42-year-old patient who has suffered three episodes of a demyelinating neuropathy, each of which followed an injection of tetanus toxoid. The clinical features on each occasion were characteristic of acute idiopathic polyneuropathy; a rapid onset of a mainly motor neuropathy with eventual recovery. Nerve conduction studies performed during the second and third episodes demonstrated grossly slowed motor conduction velocities. The sural nerve was biopsied after the third episode, and the features seen on light and electron microscopy included prominent hypertrophic changes, mononuclear cells associated with most :onion bulbs" and macrophage mediated demyelination. Studies of blastogenesis and macrophage migration inhibition, showed T lymphocyte responsiveness to both peripheral nerve myelin and tetanus toxoid. Typing for antigens of the HLA system indicated that the patient was homozygous for HLA.

Read SJ, et al. [See Related Articles] Acute transverse myelitis after tetanus toxoid vaccination. Lancet. 1992 May 2;339(8801):1111-2. No abstract available.PMID: 1349123; UI: 92236254

Robinson IG. [See Related Articles] Unusual reaction to tetanus toxoid. N Z Med J. 1981 Nov 11;94(695):359. No abstract available.PMID: 6950273; UI: 82149255.

Reijneveld JC, et al. [See Related Articles] Severe but transient parkinsonism after tetanus vaccination. J Neurol Neurosurg Psychiatry. 1997 Aug;63(2):258. No abstract available.PMID: 9285473; UI: 97429835

Sander D, et al.   Postvaccinal plexus neuropathy following vaccination against tick-borne encephalitis and tetanus in a competitive athlete. Clin Investig. 1994 May;72(5):399. No abstract available.PMID: 8086776; UI: 94369223.
Spiess H, et al. [See Related Articles] [Anaphylactic reaction following active tetanus immunization]. Dtsch Med Wochenschr. 1973 Mar 20;98(13):682. German. No abstract available.PMID: 4696498; UI: 73154013.

Ullberg-Olsson K. [See Related Articles] [Vaccination reactions after injection of tetanus toxoid with and without diphtheria toxoid]. Lakartidningen. 1979 Sep 5;76(36):2976. Swedish. No abstract available.PMID: 502666; UI: 80053529.

Schlenska GK. [See Related Articles] Unusual neurological complications following tetanus toxoid administration. J Neurol. 1977 Jul 20;215(4):299-302. No abstract available.PMID: 70523; UI: 77251623.

Vasoiu F, et al. [See Related Articles] [Considerations on tetanus in vaccinated persons, with reference to 2 cases]. Rev Med Chir Soc Med Nat Iasi. 1968 Oct-Dec;72(4):1023-5. Romanian. No abstract available.PMID: 5731137; UI: 69233143.

Vellayappan K, et al. [See Related Articles] Tetanus toxoid hypersensitivity. J Singapore Paediatr Soc. 1976 Apr;18(1):17-9. No abstract available.PMID: 966737; UI: 77010357.

Wegmann A, et al. [See Related Articles] [Local reactions after repeated tetanus vaccinations]. Schweiz Med Wochenschr. 1979 Oct 6;109(38):1409-10. German. PMID: 531542; UI: 80124006.

Weisse ME, et al. [See Related Articles] Tetanus toxoid allergy. JAMA. 1990 Nov 14;264(18):2448. No abstract available.PMID: 2146409; UI: 91039702

TETANUS

Edsall, G (1967); Elliott, MW; Peebles, TC; Levine, L; Eldred, MC; Excessive Use of Tetanus Toxoid Boosters; JAMA; Oct. 2, 1967; Vol 202, No. 1

The prevailing tetanus antibody levels on 45 children seen for routine or emergency booster injections of tetanus toxoid were all 40 to 2,500 times above the minimum protective level. Antibody levels in 22 other patients with allergic or Arthus-type reactions to tetanus toxoid were, without exception, above the threshold of protection, and all but one were many times higher. Booster doses of tetanus toxoid are being given with unnecessary and indeed excessive frequency; continuing to do this will produce a more highly toxoid-sensitive population without adding significantly to the already high protection that this immunized population has against tetanus. It is recommended that annual routine toxoid boosters of all kinds be discontinued, that routine boosters in individuals known to have had primary immunization including a reinforcing dose be given only at ten-year intervals and that emergency boosters be given no closer than one year apart.

Shimoni, Zvi; Dobrousin, Anatoly; Cohen, Jonathan; et al.   "Tetanus in an Immunised Patient" British Medical Journal Online (10/16/99) Vol. 319, No. 7216, P. 1049;
Israeli researchers present the case of a 34-year-old construction worker who was hospitalized after having a reported epileptic fit and experiencing flu-like symptoms. The patient had a low-grade fever, but was alert and coherent. Any attempts to speak or get up on the second day resulted in attacks of risus sardonicus, opisthotonus, and trismus. The patient was diagnosed with tetanus and given 2000 U of human tetanus immunoglobulin. Further treatment was provided, and after 15 days, the patient had stopped taking diazepam and ventilatory support was withdrawn. The man had been fully immunized against tetanus, and had received booster shots five and two years before being hospitalized. Antitetanus immunization has shown to be very successful, and the researchers note that it is exceedingly rare--about four cases per 100 million immunocompetent vaccinated people--for tetanus to develop after being vaccinated.

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