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.
See Table. Guide to tetanus prophylaxis in wound management.
Table. Guide to tetanus prophylaxis in wound management
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 |
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