Prevention of tetanus includes:
- Routine tetanus vaccination.
- Appropriate care of all penetrating skin wounds.
- Clean wounds thoroughly as soon as possible after an injury
- Administer tetanus vaccine and tetanus immune globulin when indicated (see below)
- Tetanus booster (Td):
- Td is a tetanus-diphtheria vaccine given to adolescents and adults as a booster shot every 10 years.
- Tdap is similar to Td but also containing protection against pertussis. A single dose of Tdap is recommended for adolescents 11 or 12 years of age.
- Td can be given up to 72 hours after a wound if someone has had 3 or more tetanus vaccines (DTaP) in the past.
- Tetanus Immune Globulin (TIG)
- TIG contains antibody to tetanus toxin. It can bind to the toxin and deactivate it. TIG may be administered (in addition to a tetanus booster) to those who are not up-to-date with their tetanus vaccinations.
Tetanus wound management is based on two factors:
- The person's tetanus vaccine status (i.e. have they received prior tetanus vaccination?)
- To complete the tetanus series, 1 dose of DTaP vaccine is recommended at each of the following ages: 2 months, 4 months, 6 months, 15-18 months, 4-6 years old.
- Td is a tetanus booster that is given to adolescents and adults as a booster shot every 10 years, although Tdap may be given instead.
- The degree of wound contamination:
- Skin wounds that must be considered include puncture wounds, lacerations, and abrasions.
- All puncture wounds with the exception of clean, minor, household wounds are considered to be dirty.
- All bites should be considered contaminated and thus require tetanus vaccine.
- Wounds that occur outdoors are considered to be dirty wounds.
- Wounds that contain dirt or soil have the highest tetanus infection risk.
Tetanus Vaccine and TIG Recommendations
|History||Clean, Minor Wound||Other Wounds|
|< 3 boosters||give Td||give Td + TIG|
|3 boosters||possible Td||possible Td|
Clean and minor wounds may need a booster if it has been more than 10 years since the last tetanus vaccine. Other wounds may need a booster if it has been more than 5 years since last tetanus vaccine.
Continue to Lockjaw Outlook
- Attygalle D, Rodrigo N. New trends in the management of tetanus. Expert Rev Anti Infect Ther. 2004 Feb;2(1):73-84. 
- Hsu SS, Groleau G. Tetanus in the emergency department: a current review. J Emerg Med. 2001 May;20(4):357-65. 
- Rhee P, Nunley MK, Demetriades D, Velmahos G, Doucet JJ. Tetanus and trauma: a review and recommendations. J Trauma. 2005 May;58(5):1082-8.