Table. Guide to tetanus prophylaxis in wound management

History of tetanus vaccination	Time since last dose	Type of wound	, combinations, , , 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

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

Last updated:

5 June 2018

Last reviewed:

5 June 2018

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

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