- Tetanus immunoglobulin (TIG) and the tetanus vaccine (Td) are both crucial in preventing symptomatic tetanus infection
- Incubation period for a tetanus infection: 1 day - 2 months
- 70% of wounds are prone to tetanus. These include contaminated wounds or puncture wounds but 30% are clean wounds. There are also case reports of surgically created wounds with autoclaved instruments resulting in tetanus 
- Past vac unknown or <3 total
- Clean wound → Td
- Dirty wound → Td & TIG
- Past vac 3 or more total
- Clean wound → Td Q10yrs
- Dirty wound → Td Q5yrs
|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|
||Consider TIG for tetanus prone wound plus Td(tetanus immune globulin)|
- 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.
- CDC. Tetanus surveillance – United States. 2001-2008. MMWR 2011,60(No. 12) Fulltext
- Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. Recommendations of the Immunization Practices Advisory committee (ACIP). MMWR Recomm Rep. 1991;40(RR-10):1-28.