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Prevention


Tetanus Prevention
Prevention of tetanus includes:
  • Routine tetanus vaccination. Images
  • 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)
Vaccination Options
  • 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. Images
  • 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. Images
    • Td is a tetanus booster that is given to adolescents and adults as a booster shot every 10 years
  • 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.
Treatment Recommendations
Clean, Minor WoundsAll Other Wounds
History / VaccineTdTIGTdTIG
Unknown or <3 dosesYesNoYesYes
3+ dosesNo*NoNo**No

(*) Yes, if greater than 10 years since last dose
(**) Yes, if greater than 5 years since last dose
(Td) Tetanus booster
(TIG) Tetanus Immune Globulin

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Last Updated: Mar 13, 2008  References
Authors: Stephen J. Schueler, MDJohn H. Beckett, MDD. Scott Gettings, MD
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