Hesperian Health Guides
Medicines to Prevent Tetanus
A person is up-to-date with tetanus vaccines, when:
- they had all 6 doses (a series of 3 as a baby, and later at least 3 boosters).
OR
- they had the series of 3 doses as a baby and at least one booster within the last 10 years.
To know which medicines are needed to prevent tetanus after a wound, you need to know if the person has been vaccinated against tetanus and when. Many people do not know if they have had these vaccines. If their vaccination history is unknown, give medicines as if they have not been vaccinated.
| Type of wound | Tetanus vaccination history | |
| Complete vaccination (3 or more doses) | Incomplete vaccination (less than 3 doses) or vaccination status unknown | |
| Minor and clean | last dose or most recent booster in the last 10 years: no medicine needed | start or complete tetanus vaccine series |
| last dose or most recent booster more than 10 years ago: give 1 dose tetanus vaccine | start or complete tetanus vaccine series | |
| Deep or dirty | last dose or most recent booster in the last 5 years:' no medicine needed | start or complete tetanus vaccine series |
| last dose or most recent booster 5 to 10 years ago: give 1 dose tetanus vaccine | start or complete tetanus vaccine series | |
| last dose or most recent booster more than 10 years ago: give 1 dose tetanus vaccine | start or complete tetanus vaccine series AND give 1 dose antitetanus immunoglobulin | |
Tetanus vaccine
- Vaccines to prevent tetanus often come combined with vaccines to prevent other illnesses. Abbreviations for such vaccines include DPT, Tdap, Td, and Dt.
- The DPT vaccine protects against diphtheria, pertussis, and tetanus and by 6 months old, babies need a series of 3 injections of this vaccine.
- Older children get 3 booster injections of DTP or another combination vaccine to prevent diphtheria and tetanus (such as Td or Dt).
- Receiving all 6 doses of these vaccines against tetanus (the series of 3 and then 3 boosters) gives protection from tetanus for decades.
- People who did not receive all 6 doses or did not have a dose within the last 10 years may need a booster vaccine.
- Giving the vaccine against tetanus to a pregnant woman whose vaccinations are not up‑to‑date helps protect both the woman and her newborn baby from tetanus.
Antitetanus immunoglobulin (human tetanus immune globulin, HyperTET)
If a person is not up-to-date with their tetanus vaccination (the series of 3 injections and at least 3 boosters, or 1 booster within the past 10 years), then give antitetanus immunoglobulin as soon as possible after a wound that could cause tetanus. If giving both the tetanus vaccine and the antitetanus immunoglobulin at the same time, give these in separate needles and do not inject antitetanus immunoglobulin in the same place on the body where you inject the tetanus vaccine. This will stop the vaccination from working.
There may be pain and tenderness where the injection was given.
Antitetanus immunoglobulin can cause a severe allergic reaction for some people. Always have epinephrine (adrenaline) available in case of an allergic reaction.
Some live virus vaccines, including those preventing measles, rubella, and tuberculosis, should not be given for 3 months after someone has received antitetanus immunoglobulin because it may make the other vaccines less effective.
Inject the medicine deep into the muscle.
For a wound less than 24 hours old
Inject 250 Units one time only.
For a wound more than 24 hours old, or a wound that is very likely to be infected with tetanus
Inject 500 Units one time only.
Also give an antibiotic such as metronidazole. For newborns with tetanus, give benzathine benzylpenicillin.