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ALL / Infectious Diseases
Tetanus: vaccination
Tetanus: vaccination
The tetanus vaccine is a cell-free purified toxin that is normally given as part of a combined vaccine.Tetanus vaccine is currently given in the UK as part of the routine immunisation schedule at:
- 2 months
- 3 months
- 4 months
- 3-5 years
- 13-18 years
This, therefore, provides 5 doses of tetanus-containing vaccine. Five doses is now considered to provide adequate long-term protection against tetanus.
Management of wounds
The Greenbook contains the full criteria. The information below is only an abbreviated summary:
The first step is to classify the wound:
| Clean wound | Tetanus prone wound | High-risk tetanus prone wound |
|---|---|---|
| Wounds less than 6 hours old, non-penetrating with negligible tissue damage |
|
Patient has had a full course of tetanus vaccines, with the last dose < 10 years ago
- no vaccine nor tetanus immunoglobulin is required, regardless of the wound severity
Patient has had a full course of tetanus vaccines, with the last dose > 10 years ago
- if tetanus prone wound: reinforcing dose of vaccine
- high-risk wounds (e.g. compound fractures, delayed surgical intervention, significant degree of devitalised tissue): reinforcing dose of vaccine + tetanus immunoglobulin
If vaccination history is incomplete or unknown
- reinforcing dose of vaccine, regardless of the wound severity
- for tetanus prone and high-risk wounds: reinforcing dose of vaccine + tetanus immunoglobulin
+PassMedicine Notes
The tetanus vaccine is a cell-free purified toxin that is normally given as part of a combined vaccine.
Tetanus vaccine is currently given in the UK as part of the routine immunisation schedule at:- 2 months
- 3 months
- 4 months
- 3-5 years
- 13-18 years
This, therefore, provides 5 doses of tetanus-containing vaccine. Five doses is now considered to provide adequate long-term protection against tetanus.
Management of wounds
The Greenbook contains the full criteria. The information below is only an abbreviated summary:
The first step is to classify the wound:
Clean wound _ Tetanus prone wound _ High-risk tetanus prone wound| Wounds less than 6 hours old, non-penetrating with negligible tissue damage _- puncture-type injuries acquired in a contaminated environment e.g. gardening injuries
- wounds containing foreign bodies
- compound fractures
- wounds or burns with systemic sepsis
- certain animal bites and scratches _
- heavy contamination with material likely to contain tetanus spores e.g. soil, manure
- wounds or burns that show extensive devitalised tissue
- wounds or burns that require surgical intervention|
- no vaccine nor tetanus immunoglobulin is required, regardless of the wound severity
- if tetanus prone wound: reinforcing dose of vaccine
- high-risk wounds (e.g. compound fractures, delayed surgical intervention, significant degree of devitalised tissue): reinforcing dose of vaccine + tetanus immunoglobulin
- reinforcing dose of vaccine, regardless of the wound severity
- for tetanus prone and high-risk wounds: reinforcing dose of vaccine + tetanus immunoglobulin
