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Melanie Jay, M.D., professor of medicine and population health at the NYU Grossman School of Medicine

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People taking metformin and acid-suppressing drugs like proton pump inhibitors over long periods of time may also develop a B-12 deficiency and should be monitored, Salinas said

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Indications Routine immunization (children & adults) Booster doses Wound management (injury with risk of tetanus) During pregnancy (to prevent neonatal tetanus) Immunization Schedule In Children Given as part of: DTaP / Pentavalent vaccine In Adults Booster every 10 years In Pregnancy 2 doses during pregnancy (if not previously immunized) Dose & Route 0.5 mL Intramuscular (IM) injection Usually in deltoid muscle (adults) Side Effects Common: Pain at injection site Redness Mild swelling Low-grade fever Rare: Severe allergic reaction (anaphylaxis) Neurological reactions (very rare) Wound Management If a patient comes with a deep wound: Doctor evaluates: Immunization history Type of wound If vaccination incomplete Tetanus toxoid + Tetanus immunoglobulin may be given

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