Tetanus

Disease Risk Areas
Worldwide.

Transmission
Tetanus spores are present in soil from contamination with human, animal and bird faeces and enter the body through injuries.

Primary immunisation of children
Given in Britain as "triple vaccine" (DPT) from 2 months of age. Immunisation is started as early as 1 month in some countries. If the pertussis component is contraindicated adsorbed Diphtheria/Tetanus vaccine should be given.

Primary immunisation of adults
Adsorbed tetanus vaccine given in 3 doses either at monthly intervals as for children, or the third dose can be delayed for up to 6 months.

Boosters
Should be given 5 years after a primary course and then after 10 years. For life in Britain these 5 doses are considered sufficient unless the unless the risk of contaminated injuries is considered to be likely.
If an injury occurs and a booster has not been received within 10 years, a booster should then be given, ideally with tetanus hyperimmune globulin.
Travellers may warrent additional 10 yearly boosters if they are going to countries where specific tetanus immunoglobulin will not be available and tetanus prone injuries are possible.

Vaccination

Type: Inactivated
Primary vaccination: 3 doses(adsorbed)
Dosage: 0.5ml
Route: Deep S/C or I/M
Length of protection: 5-10 years
Boosters: 5 years after primary course and then after 10 years. (See below for recommendations regarding additional boosters)

Side effects
Local reactions may occur but systemic reactions are rare.

Contraindications
Acute febrile illness (except when the patient is being immunised following a tetanus prone wound). Severe reaction to a preceding dose.
Hypersensitivity is common if booster doses are given too frequently. Marked soreness and inflammation around a tetanus vaccination site usually equates to adequate immunity.