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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 uncertain^b	Uncertain	Clean, minor wounds	Yes	No
<3 doses or uncertain^b	Uncertain	All other wounds	Yes	Yes
^aGive 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-toxoid vaccine. ^b People who have no documented history of a complete primary vaccination course (3 doses) with a tetanus-toxoid 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

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Last updated

30 June 2023

Last reviewed

30 June 2023

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