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

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Diphtheria, tetanus, and poliomyelitis are notifiable diseases.


Diphtheria is an acute infection usually affecting the nasopharynx caused by the bacterium Corynebacterium diphtheria, and can affect all ages. The organism is spread by respiratory droplets and has an incubation period of two to five days.


Tetanus is an infection characterised by painful muscular contractions. It is caused by the bacterium Clostridium tetani and can affect any age. The organism is ubiquitous in the environment and has an incubation period from one day to several months.


Polio (Poliomyelitis) is an infection characterised by the acute onset of flaccid paralysis. It is caused by Poliovirus type 1, 2 or 3, and can affect all ages. The organism is spread by the faecal-oral route and has an incubation period of 7 – 14 days.

The vaccine

Revaxis is given at around 14 years old as part of the national schedule. This is about 10 years after the pre-school booster, which is routinely given at 3 years and 4 months.

Revaxis is an inactivated injectable vaccine in a pre-filled syringe presentation.

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

Revaxis can be used in the management of tetanus prone injuries in children, young people and adults over 10 who are not up to date with their primary course of tetanus containing immunisations. Tetanus immunoglobulin should be administered concomitantly in accordance with official recommendations.

Guidance on the treatment of tetanus cases and management of tetanus prone wounds advice for health professionals.

Summary of product characteristics

The Complete Routine Immunisation Schedule includes information about routine and non-routine vaccinations.



Vaccination programme recommendations from the Joint Committee on Vaccination and Immunisation (JCVI) and Welsh Government policy can be found at the links below.

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

Welsh Health Circulars and Welsh Government letters

NES - Unscheduled Immunisations for Children and Young Adults (June 2019)



Training resources and events

Online courses and training materials about a number of vaccines and diseases can be accessed via the E-learning page.

Further immunisation training information and resources are provided on the Training Resources and Events page.


Clinical resources and information

Diphtheria –the green book, chapter 15

Tetanus – the green book, chapter 30

Polio – the green book, chapter 26

Tetanus: advice for health professionals

Vaccination of individuals with uncertain or incomplete immunisation status - GOV.UK

Patient group directions (PGDs) and protocols

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

Further clinical resources and information


Data and surveillance