Hesperian Health Guides
Medicines to Prevent Tetanus
First Aid: Medicines
Some wounds can cause tetanus unless the person has already had the necessary vaccinations. Antitetanus immunoglobulin and the tetanus vaccine are 2 medicines given by injection that prevent tetanus after a wound. One or both are needed depending on whether the person is up-to-date with tetanus vaccinations and the seriousness of the wound. Give the necessary injections as soon as possible. Do not wait for signs of 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).
- They had the first 3 doses and at least one booster within the last 10 years.
To know which medicines to prevent tetanus are needed, it is best to know if the person has had a vaccine 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 are not up-to-date with their vaccines.
- If the wound is deep or dirty and the person has not had a tetanus vaccine within the last 5 years or their vaccination history is unknown.
- For any wound, even one that is minor and clean, if it is not certain that the person received at least 3 vaccinations against tetanus (the first 3 doses are usually given during a baby’s first year).
- If the wound is deep or dirty and 5 years or more has passed since the most recent tetanus vaccine or vaccine booster.
- If the wound is minor and clean and 10 years or more has passed since the most recent tetanus vaccine or vaccine booster.
- If the wound is deep or dirty but the most recent tetanus vaccine was within the last 5 years.
- If the wound is minor and clean and the person is up-to-date with their tetanus vaccines.
But if the person has HIV or another illness that lowers their immunity, give antitetanus immunoglobulin for any wound, even a minor one. If they are not up-to-date with the tetanus vaccine, they will need the tetanus vaccine too.
- Vaccines to prevent tetanus often come combined with other vaccines. Abbreviations for such vaccines include: DPT, Tdap, Td, Dt and others.
- 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 one 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)
If a person is not up-to-date with their tetanus vaccination (the series of 3 injections, and at least 3 boosters, or one booster within the past 10 years), then they should be given antitetanus immunoglobulin as soon as possible after getting a wound that might cause tetanus. If giving both the tetanus vaccine and the antitetanus immunoglobulin at the same time, use separate needles and inject in different places on the body.
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 OR penicillin G.