Tetanus Immunization in Individuals with a History of Seizures

Key Considerations

The American Academy of Pediatrics recommends that tetanus-containing vaccines are not contraindicated in patients with stable neurologic disorders, including well-controlled seizures, and should be administered with appropriate monitoring 1, 2, 3
For individuals with unstable or progressive neurologic disorders, pertussis-containing vaccines should be deferred until the neurologic condition has stabilized, and Td or DT should be used instead to maintain tetanus protection 1, 2, 3, 4
The Centers for Disease Control and Prevention states that anaphylaxis to a previous dose or vaccine component is a contraindication to tetanus vaccination, as is encephalopathy within 7 days of a previous pertussis-containing vaccine dose 1, 2, 3, 4
The American Academy of Pediatrics suggests that acetaminophen can be administered prophylactically to prevent fever in high-risk patients, such as those with a personal history of seizures or family history of convulsions 5, 6
Patients with a history of Guillain-Barré syndrome within 6 weeks of a previous tetanus-containing vaccine require a risk-benefit assessment before receiving another tetanus-containing vaccine 1, 2, 3, 4

For patients with stable seizure disorders, the standard tetanus vaccination schedule should be followed, with consideration of prophylactic acetaminophen and monitoring for allergic reactions 1, 2, 3, 5, 6, 7
For patients with unstable seizures, Td should be used instead of Tdap, and vaccination should be deferred until the neurologic status is clarified and stabilized 1, 2, 3, 4