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Tetanus, diphtheria and polio (Td/IPV or 3-in-1) - Information for health professionals

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Background

The Td/IPV vaccine, also known as the teenage 3-in-1 booster, is given to boost protection against 3 separate diseases: tetanus (external site), diphtheria (external site) and polio (external site)

Tetanus, diphtheria and polio are notifiable diseases.

Tetanus

Tetanus (external site) is an acute disease resulting in generalised rigidity and spasms of skeletal muscles. Tetanus bacteria, which is found in soil and manure, can be introduced to the body through a wound, burn or scratch and subsequently releases the tetanus toxin. The incubation period is between 4 and 21 days. 

Diphtheria

Diphtheria (external site) is an acute infectious disease caused by diphtheria toxin which affects the upper respiratory tract and/or the skin. The organism is spread by droplets and contact with contaminated items, and has an incubation period of 2 to 10 days. This disease is now very rare in the UK. 

Poliomyelitis

Poliomyelitis (external site) (polio) is an acute illness caused by polio virus subtypes 1, 2 or 3. Invasion occurs via the gastrointestinal tract and typically spreads to attack nervous tissue, resulting in meningitis or paralysis. The incubation period is between 3 and 21 days.  

The vaccine, dosage and administration 

The brand name of the teenage 3-in-1 booster vaccine given in the UK is Revaxis® (external site). It's an inactivated injectable vaccine in a 0.5ml dose, pre-filled syringe, and should be given by intramuscular injection, preferably into the deltoid muscle of the upper arm. 

It does not contain any live bacteria or viruses and cannot cause any of the diseases it protects against. 

Revaxis® is given at around 13 to14 years of age (school year 9) as part of the Routine immunisation schedule for Wales, which is usually about 10 years after the pre-school booster.  

The teenage 3-in-1 booster vaccination is routinely offered at the same time as the MenACWY vaccine.  Most inactivated vaccines can usually be administered at any time before, after, or at the same time as each other, unless stated otherwise. Doses of inactivated vaccines can also be given at any interval before, after, or at the same time as a live vaccine.  

Where two or more injections are administered at the same time, they should be given at separate sites, preferably in a different limb. If more than one injection is to be given in the same limb, they should be administered at least 2.5cm apart.  

Summary of product characteristics

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. You should report suspected adverse reactions of vaccines and medicines online at mhra.gov.uk/yellowcard (external site), by downloading the Yellow Card app, or by calling 0800 731 6789 (Monday to Friday, 9am to 5pm). 

 

Guidance

Vaccination programme recommendations from the Joint Committee on Vaccination and Immunisation (JCVI) and Welsh Government policy: 

Joint Committee on Vaccination and Immunisation - GOV.UK (external site) (read JCVI publications and statements; search e.g. tetanus, diphtheria, polio) 

Welsh Health Circulars and Welsh Government letters 

Children and adults who have outstanding routine immunisations: national supplementary service specification | GOV.WALES (external site)  August 2025  

 

Training resources and events

Information and training resources for health professionals are provided on the Training Resources and Events page. 

Online courses for health professionals involved in vaccination can be accessed via ESR and are linked from the Immunisation eLearning - Public Health Wales page. 

 

Clinical resources and information

 

Diphtheria – the green book (external site) 

Tetanus – the green book (external site) 

Polio – the green book (external site) 

Tetanus: advice for health professionals (external site) 

Vaccination of individuals with uncertain or incomplete immunisation status - GOV.UK (external site) 

 

Patient group directions (PGDs) and protocols

PGD templates for vaccines can be found on the Patient group directions (PGDs) and protocols page. 

Vaccine resources 

 

Further school age resources available from Vaccine resources for health and social care workers   

The Complete Routine Immunisation Schedule includes information about routine and selective immunisation programmes and additional vaccines that may need to be considered for individuals with underlying medical conditions.   

 

 

Data and surveillance