How to Help Your Patients Find Td Vaccine in Stock After TdVax: A Provider's Guide

When a patient walks into your office needing a tetanus and diphtheria booster — or calls after a wound injury — the question of "where do I get a Td vaccine?" has become more complex than it was a few years ago. TdVax is permanently discontinued. Tenivac is under CDC ordering controls. And while Tdap vaccines are available, not every patient can receive them. This guide gives providers a practical toolkit for helping patients navigate the current Td vaccine landscape.

Step 1: Determine What Your Patient Actually Needs

Before searching for vaccine availability, clarify your patient's clinical needs with two key questions:

1. Does this patient have a contraindication to the pertussis component? If yes, they need Tenivac — the only remaining Td-only vaccine. If no, Tdap (Adacel or Boostrix) is the CDC's preferred option and is clinically superior for most patients due to pertussis protection.
2. Is this urgent (wound management) or routine (10-year booster)? Wound management is time-sensitive. If the correct vaccine isn't immediately available at your practice, identify the nearest source quickly rather than waiting for the "ideal" option.

Step 2: Check Your Own Practice's Inventory

Many physician offices and urgent care clinics stock at least one Td or Tdap vaccine on hand. If your practice stocked TdVax and hasn't updated its formulary since the discontinuation, now is the time to act. Contact your vaccine distributor (AmerisourceBergen, McKesson, Cardinal Health, or your state health department public sector supply) to order Adacel, Boostrix, and a reserved stock of Tenivac for contraindicated patients.

For Tenivac specifically, be aware that CDC ordering controls may limit the quantity you can purchase per order cycle. Document your contraindicated patient population size to inform how much Tenivac to keep on hand.

Step 3: Use External Pharmacy Networks to Locate Vaccines for Patients

If your practice cannot administer the vaccine your patient needs, efficient referral to a nearby pharmacy or clinic is critical. The challenge is that pharmacy online tools don't always accurately reflect real-time vaccine inventory, and calling each pharmacy individually is time-consuming for your staff.

Services like medfinder for providers can call pharmacies on a patient's behalf to confirm which ones have a specific vaccine in stock. This works well for Tenivac searches, where availability varies significantly by location and day. Directing your patient to use medfinder can reduce return calls to your office and get them vaccinated faster.

Step 4: Know the Non-Retail Pharmacy Network

When retail pharmacy chains are out of Tenivac, consider the following alternative sources your patients may not think of on their own:

• County and city health departments: Public sector health departments often receive vaccine allocations from CDC's public-sector supply channel. They sometimes have Tenivac when retail pharmacies do not.
• Federally Qualified Health Centers (FQHCs): FQHCs often have access to 317 grant-funded vaccines and may have supply when retail chains do not.
• Hospital outpatient pharmacies and infusion centers: Hospital systems often maintain separate vaccine procurement channels and may have Tenivac in stock.
• Travel medicine clinics: These specialized clinics often carry a wider variety of vaccines than general retail pharmacies and may have Tenivac available.
• Occupational health services: For patients whose employer has an occupational health department, this is often an overlooked resource with direct vaccine procurement relationships.

Step 5: Streamline Your Referral Process

Consider creating a simple office protocol that your medical assistants and nurses can follow when a patient needs a vaccine your practice doesn't have in stock:

1. Determine vaccine needed (Tenivac vs. Tdap) based on patient record and physician order
2. Provide patient with written note specifying the exact vaccine (Tenivac, Adacel, or Boostrix)
3. Direct patient to use medfinder or your health system's pharmacy locator tool
4. For urgent wound management cases, call ahead to the nearest urgent care or ED on the patient's behalf and confirm vaccine availability
5. Follow up to confirm vaccination was administered and update the patient's immunization record

Patient Communication Templates

When communicating with patients about the TdVax discontinuation, clarity is key. Here are suggested talking points for your staff:

• "TdVax is no longer being made. Your doctor has recommended [Tenivac/Adacel/Boostrix] as the appropriate alternative for you."
• "[Adacel/Boostrix] provides all the same tetanus and diphtheria protection as TdVax, plus protection against whooping cough, so it's actually a bit more comprehensive."
• "If we don't have it in the office today, we'll help you find a pharmacy near you that does."

For a deeper clinical overview of the TdVax situation, read: TdVax Discontinuation: What Providers and Prescribers Need to Know in 2026.