People with a tetanus-prone wound and a humoral immune deficiency (including HIV) are recommended to receive tetanus immunoglobulin
People with a humoral immune deficiency and people with HIV (regardless of CD4+ count) are recommended to receive tetanus immunoglobulin if they have a tetanus-prone injury. This is regardless of the time since their last dose of tetanus-containing vaccine.
These people may not have developed or maintained adequate immunity to tetanus, despite vaccination.
History of tetanus vaccination |
Time since last dose |
Type of wound |
DTPa, DTPa combinations, dT, dTpa, as appropriate |
Tetanus immunoglobulin |
≥3 doses |
<5 years |
Clean, minor wounds |
No |
No |
≥3 doses |
<5 years |
All other wounds |
No |
No (unless person has immunodeficiency)a |
≥3 doses |
5–10 years |
Clean, minor wounds |
No |
No |
≥3 doses |
5–10 years |
All other wounds |
Yes |
No (unless person has immunodeficiency)a |
≥3 doses |
>10 years |
Clean, minor wounds |
Yes |
No |
≥3 doses |
>10 years |
All other wounds |
Yes |
No (unless person has immunodeficiency)a |
<3 doses or uncertainb |
Uncertain |
Clean, minor wounds |
Yes |
No |
<3 doses or uncertainb |
Uncertain |
All other wounds |
Yes |
Yes |
a.Give tetanus immunoglobulin to people with a humoral immune deficiency and people with HIV (regardless of CD4+ count) if they have a tetanus-prone injury. This is regardless of the time since their last dose of tetanus-containing vaccine.
b. People who have no documented history of a complete primary vaccination course (3 doses) with a tetanus-containing vaccine should receive all missing doses and must receive tetanus immunoglobulin for tetanus-prone wounds. See Catch-up vaccination.
Source: Cox et al,6 Fraser,7 Lucas and Willis,8 McComb,9 Smith et al,10 Trinca11
Page history
Definitions
- DTPa
- diphtheria-tetanus-acellular pertussis vaccine
- dT
- diphtheria-tetanus vaccine for use in adults
- dTpa
- diphtheria-tetanus-acellular pertussis vaccine, reduced antigen content formulation
Printed content may be out of date. For up to date information, always refer to the digital version: https://immunisationhandbook.health.gov.au/recommendations/people-with-a-tetanus-prone-wound-and-a-humoral-immune-deficiency-including-hiv-are.