Guidance for Tetanus-Diphtheria Vaccination during the 2017 Td Vaccine Shortage

Background

Td vaccine is expected to be in short supply through September 2017:

Sanofi’s Td vaccine (Tenivac) has been unavailable since November 2016.
The only other Td vaccine approved for use in the U.S. (MassBiologics Td vaccine, distributed by Grifols) has been available since then, but Grifols predicts shipping delays and partial shipments through the first half of September due to high demand.
Sanofi anticipates resuming distribution of Tenivac in mid August 2017.

Guidance for Vaccinating People for Whom Td is Indicated During this Shortage

Td vaccine is routinely indicated for use in three situations:

Decennial tetanus-diphtheria boosters
Primary tetanus-diphtheria series for adolescents and adults
Management of tetanus-prone wounds

During the shortage, continue using Td in these situations if it is available.

Although Tdap is recommended for only a single lifetime dose (with the exception of pregnant women), it may be used in place of Td during this shortage:

If Td is NOT available:

Booster:
- Patient has never received Tdap: Use Tdap.
- Patient has previously received Tdap: Using Tdap in place of Td at the discretion of the provider is
- a reasonable alternative.
Primary Series: Using Tdap in place of Td at the discretion of the provider is a reasonable alternative.
Wound Management: Use Tdap even if the patient has received Tda