Tetanus prophylaxis

Background

Incubation Period: 1dy - 2 mo

Prophylaxis

1. Past vac unknown or <3 total
   1. Clean wound --> Td
   2. Dirty wound --> Td & TIG
2. Past vac 3 or more total
   1. Clean wound --> Td Q10yrs
   2. Dirty wound --> Td Q5yrs

Tetanus Vaccine Selection Guide

Age	If No Pertussis Contraindications	If Pertussis Contraindicated	Comments
2mo - 7yrs	DTaP	DT	DT available from pharmacy
7yrs - 10yrs	Td	Td
10yrs	Tdap(Adacel)^	Td	^Off label use, but appears safe and immunogenic
11yrs - 16yrs	Tdap(Adacel)	Td
16yrs - 65	Tdap(Adacel)^^	Td	^^Use Td if patient is known to have received prior Tdap
65yrs +	Td	Td	Consider TIG for tetanus prone wound plus Td(tetanus immune globulin)

Caveats

• Adolescents who have already gotten a booster dose of Td are encouraged to get a dose of Tdap as well. Waiting 5 years after their last Td is encouraged but not required. A period of at least 2 years between Td and Tdap is recommended in these cases.
• Pregnancy is not a contraindication to Tdap. The only true contraindication to tetanus immunization is a history of neurologic or severe hypersensitivity to a previous dose.
• Stable neurologic disorders and family history of vaccine reactions are not contraindications to receiving these vaccines.
• No vaccine has ever been shown to play any role in the development of autism or autism spectrum disorders.

See Also

Tdap (Pertussis Vaccine) for new recommendations from CDC

Tetanus (Acute)

Source

Epocrates