Comprehensive medication guide to Tenivac including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0 under most ACA-compliant private insurance plans (preventive care benefit); $0 under Medicare Part D since 2023; $0 with Medicaid. Uninsured cash price varies from $50–$97 plus administration fees.
Estimated Cash Pricing
$50–$97 retail per dose; GoodRx prices start at $50.04 and SingleCare reduces cost to approximately $50.22 with their savings card for a single 0.5 mL dose.
Medfinder Findability Score
45/100
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Tenivac is a brand-name Td (tetanus and diphtheria toxoids adsorbed) vaccine manufactured by Sanofi Pasteur. It is given as a 0.5 mL intramuscular injection and is FDA-approved for active immunization against tetanus and diphtheria in persons 7 years of age and older. As of 2024, Tenivac is the only Td vaccine available in the United States after MassBiologics discontinued its TdVax product.
Tenivac is used for routine booster immunization every 10 years, for primary immunization series in unvaccinated individuals, and for tetanus prophylaxis after wounds. It does NOT contain the pertussis (whooping cough) component found in Tdap vaccines like Adacel and Boostrix.
Each 0.5 mL dose contains 5 Lf of tetanus toxoid and 2 Lf of diphtheria toxoid, with 1.5 mg of aluminum phosphate (0.33 mg aluminum) as an adjuvant and residual formaldehyde (≤5.0 mcg). The vaccine is stored refrigerated between 36–46°F (2–8°C) and must not be frozen.
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Tenivac is a toxoid vaccine. Tetanus and diphtheria bacteria cause disease through the potent toxins they produce. Sanofi manufactures Tenivac by chemically inactivating these toxins with formaldehyde, creating toxoids that look identical to the real toxins to your immune system but cannot cause harm.
After injection, your immune system's antigen-presenting cells recognize the toxoids as foreign, triggering B cells to produce antibodies specifically shaped to neutralize them. Long-lived memory B and T cells form and "remember" what tetanus and diphtheria toxins look like. If you are later exposed to the actual toxins, these memory cells rapidly produce neutralizing antibodies, preventing disease.
The aluminum phosphate adjuvant in Tenivac enhances immune response by creating a local inflammatory reaction at the injection site that recruits immune cells, resulting in stronger and more durable antibody production. Because antibody levels naturally wane over approximately 10 years, booster doses are recommended on a decennial schedule throughout adulthood.
5 Lf tetanus toxoid / 2 Lf diphtheria toxoid — injection
0.5 mL intramuscular suspension; available as single-dose vial or prefilled syringe
Tenivac availability has been constrained since early 2024, when MassBiologics discontinued TdVax and left Sanofi's Tenivac as the sole Td vaccine in the US market. The CDC imposed temporary ordering limits and recommended switching to Tdap vaccines (Adacel/Boostrix) whenever possible. Supply has partially stabilized since mid-2024, but localized shortages still occur at individual pharmacies and regions.
Tenivac's findability score is 45 out of 100, reflecting frequent localized shortages. Chain pharmacies sometimes carry it but availability varies widely. Hospital outpatient pharmacies, travel medicine clinics, urgent care centers, and county health departments are often better sources. Patients who specifically need Tenivac (not Tdap) due to pertussis vaccine contraindications will find the search most challenging.
Use medfinder to find pharmacies near you that currently have Tenivac in stock. medfinder calls pharmacies on your behalf and texts you results — saving hours of frustrating phone calls.
Tenivac is a prescription-only vaccine but is not a controlled substance and requires no DEA scheduling. A wide variety of licensed healthcare providers can prescribe and/or administer it. In many states, pharmacists can administer Tenivac under standing orders without a patient-specific prescription.
Primary care physicians (PCPs) and family medicine physicians
Pediatricians (for patients ages 7 and older)
Internists and geriatricians
OB-GYNs (for wound management in pregnancy)
Emergency medicine and urgent care physicians
Travel medicine specialists
Nurse practitioners (NPs) and physician assistants (PAs)
Pharmacists (under standing orders in most states)
Telehealth providers can review vaccination history and issue a Tenivac prescription, but cannot administer the vaccine. The injection must be given in person by a licensed healthcare professional at a clinic, pharmacy, or provider's office.
No. Tenivac is not a controlled substance and is not scheduled by the DEA. It is a prescription vaccine but has no abuse potential, does not cause dependence, and is not subject to controlled substance prescribing or dispensing restrictions.
In many states, pharmacists can administer Tenivac under standing orders without a patient-specific prescription. However, Tenivac is prescription-only and cannot be purchased over the counter — it must be administered by a licensed healthcare professional. Refill restrictions do not apply since it is given as a single-dose injection at scheduled intervals.
Most side effects are mild and resolve within 1–3 days:
Injection site pain (~80% of patients)
Injection site redness and swelling (~25%)
Headache (~25%)
Fatigue and malaise (~25%)
Muscle weakness and joint pain (~10%+)
Low-grade fever
Anaphylaxis (rare): Severe allergic reaction — seek emergency care immediately
Guillain-Barré Syndrome (very rare): Progressive muscle weakness; seek emergency care
Brachial neuritis (rare): Severe sudden shoulder pain and limited range of motion
Arthus-type reaction: Severe local hypersensitivity — do not revaccinate more than once per 10 years
Syncope (fainting): Remain seated 15 minutes post-injection
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Adacel
Tdap vaccine by Sanofi Pasteur; covers tetanus, diphtheria, AND pertussis. Approved ages 10–64. CDC's preferred substitute during Tenivac shortage. Widely available without supply constraints.
Boostrix
Tdap vaccine by GSK; covers tetanus, diphtheria, AND pertussis. Approved for ages 10+. Preferred for adults 65+ and pregnant women (gestational weeks 27–36). Also widely available.
TdVax (TDVAX)
Generic Td vaccine by MassBiologics — permanently discontinued in 2024. No longer available in the US market.
Prefer Tenivac? We can find it.
Biologic immunosuppressants (adalimumab, belimumab, anakinra, etanercept, infliximab)
majorSignificantly decrease vaccine response; may contraindicate concurrent administration. Discuss timing with prescriber.
Corticosteroids (high-dose systemic)
moderateImmunosuppressive effects reduce vaccine effectiveness when used at greater than physiologic doses for extended periods.
Chemotherapy agents / antimetabolites / alkylating agents
majorCan severely impair immune response; vaccine timing should be coordinated around chemotherapy cycles.
Radiation therapy
moderateMay reduce vaccine-induced immune response. Coordinate timing with radiation oncologist.
Live vaccines (MMR, varicella, yellow fever)
minorNo specific interaction with Tenivac, but live vaccines should be given on the same day as Tenivac or separated by 4+ weeks from other live vaccines.
Blood thinners (warfarin, apixaban, rivaroxaban)
minorNo contraindication; inform provider for injection technique modification to minimize bruising.
Tenivac remains an essential vaccine for patients who need Td-only immunization — particularly those who cannot receive the pertussis component in Tdap vaccines, and children ages 7–9. While the 2024 shortage eased somewhat as Sanofi ramped up production, Tenivac availability still varies significantly by region and pharmacy type in 2026.
For patients who can receive Tdap, switching to Adacel or Boostrix is CDC-endorsed and provides broader protection against pertussis in addition to tetanus and diphtheria. For those who specifically need Tenivac, expand your search to hospital pharmacies, travel clinics, urgent care centers, and public health clinics — and use tools that call pharmacies on your behalf.
If you need help finding Tenivac in stock near you, medfinder can call pharmacies on your behalf and text you results — saving you hours of frustrating phone calls and trips to out-of-stock locations.
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