Tetanus vaccine adverse reactions

Adverse reactions to tetanus toxoid

Akama K, Yamamoto A.  [Side effects of tetanus toxoid. II. Antigenic materials derived from the constituents of the medium for toxoid preparation] Nippon Saikingaku Zasshi. 1969 Nov;24(11):595-601. Japanese. No abstract available. PMID: 5391905
Baust W, Meyer D, Wachsmuth W. Peripheral neuropathy after administration of tetanus toxoid.J Neurol. 1979;222(2):131-33. PMID: 93631 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.

Blumstein GI, Kreithen H.Peripheral neuropathy following tetanus toxoid administration.JAMA. 1966 Nov 28;198(9):1030-1. No abstract available. PMID: 4288653 [PubMed - indexed for MEDLINE]

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.

Chanukoglu A, Fried D, Gotlieb A. [Anaphylactic shock due to tetanus toxoid] Harefuah. 1975 Nov 16;89(10):456-7. Hebrew. No abstract available. PMID: 1205376 [PubMed - indexed for MEDLINE]

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.

Dal Bo S.  [Allergic reactions against anti-tetanus toxoid]Folia Allergol (Roma). 1969 Jan-Feb;16(1):63-73. Italian. No abstract available. PMID: 5772158 [PubMed - indexed for MEDLINE]
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.
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.

Eibl MM, Mannhalter JW, Zlabinger G.  Abnormal T-lymphocyte subpopulations in healthy subjects after tetanus booster immunization.N Engl J Med. 1984 Jan 19;310(3):198-9. No abstract available.PMID: 6228737 [PubMed - indexed for MEDLINE]
"As reported in a letter to the New England Journal of Medicine in 1984, tests of T-lymphocyte subpopulations were done on 11 healthy adults before-and-after routine tetanus booster immunizations. Tests showed a significant though temporary drop in T-helper lymphocytes (a class of white blood cells which helps govern the immune system) in all of the subjects. Special concern rests in the fact that in 4 of the subjects the T-helper cells fell to levels found in active AIDS patients. (2) If this was the result of a single vaccine in healthy adults, it is sobering to think of the consequences of the multiple vaccines (twenty-one at last count) routinely given to infants with their immature systems during the first six months of life. However, we can only speculate as to the consequences, as this test has never been repeated."--Dr Buttram MD

Ehrengut W, Staak M.  [Anaphylactic reaction following injection of tetanus toxoid] Dtsch Med Wochenschr. 1973 Mar 9;98(10):517. German. No abstract available. PMID: 4691574 [PubMed - indexed for MEDLINE

Eicher W, Neundorfer B.  [Paralysis of the recurrent laryngeal nerve following a booster injection of tetanus toxoid (associated with local allergic reaction)] Munch Med Wochenschr. 1969 Aug 22;111(34):1692-5. German. No abstract available. PMID: 5820101
Fardon DF.  Unusual reactions to tetanus toxoid. JAMA. 1967 Jan 9;199(2):125-6. No abstract available. PMID: 6071146

Facktor MA, Bernstein RA, Fireman P.  Hypersensitivity to tetanus toxoid. J Allergy Clin Immunol. 1973 Jul;52(1):1-12. No abstract available. PMID: 4268453 [PubMed - indexed for MEDLINE]

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

Fischmeister M.  [Letter: Acute reaction following injection with tetanus toxoid] Dtsch Med Wochenschr. 1974 Apr 19;99(16):850. German. No abstract available. PMID: 4828666 [PubMed - indexed for MEDLINE]

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.

Griffith RD, Miller OF 3rd.  Erythema multiforme following diphtheria and tetanus toxoid vaccination. J Am Acad Dermatol. 1988 Oct;19(4):758-9. No abstract available. PMID: 2972761

Graham DR.  Reactions to tetanus toxoid. JAMA. 1983 Sep 9;250(10):1273-4. No abstract available. PMID: 6876314
Gersbach P, Waridel D.  [Paralysis after tetanus prevention] Schweiz Med Wochenschr. 1976 Jan 31;106(5):150-3. French. PMID: 1251167
Grond M, Gibbels E, Schadlich HJ, Haupt WF.  [Polyneuropathies following administration of tetanus toxoid] Nervenarzt. 1988 May;59(5):309-12. German. PMID: 3405346 [PubMed - indexed for MEDLINE]
Holliday PL, Bauer RB.  Neurologic complications of tetanus toxoid. Arch Neurol. 1983 Oct;40(10):659. No abstract available. PMID: 6615279 Holliday PL, Bauer RB.  Polyradiculoneuritis secondary to immunization with tetanus and diphtheria toxoids. Arch Neurol. 1983 Jan;40(1):56-7. No abstract available. PMID: 6848095 [PubMed - indexed for MEDLINE]

Harrer G, Melnizky U, Wendt H.  [Accommodation paresis and swallowing paralysis following tetanus toxoid booster inoculation] Wien Med Wochenschr. 1971 Apr 10;121(15):296-7. German. No abstract available. PMID: 5555154 [PubMed - indexed for MEDLINE]

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.
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

Kiwit JC.  Neuralgic amyotrophy after administration of tetanus toxoid. J Neurol Neurosurg Psychiatry. 1984 Mar;47(3):320. No abstract available. PMID: 6707685 [PubMed - indexed for MEDLINE]
Korableva NN, Protopopova II.  [Complications after specific prevention of tetanus] Khirurgiia (Mosk). 1987 Jan;(1):90-3. Russian. No abstract available. PMID: 3560716 [PubMed - indexed for MEDLINE]

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.
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.

Mansfield LE, Ting S, Rawls DO, Frederick R.Systemic reactions during cutaneous testing for tetanus toxoid hypersensitivity. Ann Allergy. 1986 Aug;57(2):135-7. No abstract available. PMID: 3740557 [PubMed - indexed for MEDLINE]

Olutade BO, Awotedu AA, Ukoli CO.  Neurological complication following tetanus toxoid immunization. A case report.West Afr J Med. 1992 Jul-Sep;11(3):221-2. Review. PMID: 1476968 [PubMed - indexed for MEDLINE]
A 33-year-old Nigeria male developed fever, malaise, headache, muscle weakness and polyneurutis 24 hours after administration of tetanus toxoid. These manifestations however cleared within 72 hours. No other identifiable agents or predisposing factors were identified to explain this phenomenon.

Reinstein L, Pargament JM, Goodman JS.  Peripheral neuropathy after multiple tetanus toxoid injections. Arch Phys Med Rehabil. 1982 Jul;63(7):332-4. PMID: 6284088 [PubMed - indexed for MEDLINE]
This case documents the 14th reported patient with peripheral neuropathy following tetanus toxoid injection. A 33-year-old man developed profound mixed sensorimotor peripheral neuropathy after receiving 2 tetanus toxoid injections over a 5-month period. Periodic serial electromyographic and nerve conduction studies performed over 2 years suggested both segmental demyelination and axonal neuropathy. The patient experienced partial recovery. Analysis of this case and 13 others reported in literature indicates that in almost all cases (85%), patients had received multiple tetanus toxoid injections. Also, it appears that a prolonged interval of 14 or more days between the tetanus toxoid injection and the onset of neurological symptoms is associated with a poorer prognosis for complete recovery.

Schabet M, Wiethoelter H, Grodd W, Vallbracht A, Dichgans J, Becker W, Berg PA.   Neurological complications after simultaneous immunisation against tick-borne encephalitis and tetanus. Lancet. 1989 Apr 29;1(8644):959-60. No abstract available. PMID: 2565447 [PubMed - indexed for MEDLINE]

Sutter RW.  Adverse reactions to tetanus toxoid. JAMA. 1994 May 25;271(20):1629. No abstract available. PMID: 8182821

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.

Steigman A.  Allergic reactions to tetanus toxoid. J Pediatr. 1968 Oct;73(4):648-9. No abstract available. PMID: 4175803

Tezzon F, Tomelleri P, Ferrari G, Sergi A.  Acute radiculomyelitis after antitetanus vaccination.Ital J Neurol Sci. 1994 May;15(4):191-3. Review.PMID: 7960672 [PubMed - indexed for MEDLINE]
We report the assessment by MRI of a case of radiculomyelitis after vaccination against tetanus-poliomyelitis. In the acute stage the appearance was an isolated myelitis of the conus medullaris with contrast enhancement. The upper thoracic cord presented central areas of high signal intensity on T2 weighted images. Rapid clinical recovery was correlated with resolution of abnormal enhancement. Follow-up MR at 5 months showed persistence of slight T2 prolongation in the conus medullaris and syringohydromyela of the thoracic cord. A single lesion of the spinal cord is a rare presentation of acute disseminated encephalomyelitis, the course of such lesions, to date not previously displayed by MR, is unknown. Proper diagnosis should help prevent administration of further vaccine doses.
Topaloglu H, Berker M, Kansu T, Saatci U, Renda Y.  Optic neuritis and myelitis after booster tetanus toxoid vaccination. Lancet. 1992 Jan 18;339(8786):178-9. No abstract available. PMID: 1346027

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.
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.

Wiseman TL.  Anaphylactic reaction to tetanus toxoid. Ann Allergy. 1982 Nov;49(5):308. No abstract available. PMID: 7149344

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

White WG, Barnes GM, Barker E, Gall D, Knight P, Griffith AH, Morris-Owen RM, Smith JW.   Reactions to tetanus toxoid. J Hyg (Lond). 1973 Jun;71(2):283-97. No abstract available. PMID: 4515879
Zaloga GP, Chernow B.  Life-threatening anaphylactic reaction to tetanus toxoid. Ann Allergy. 1982 Aug;49(2):107-8. No abstract available. PMID: 7103147


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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