Because established tetanus is often fatal, even with expert treatment, prevention is of paramount importance. The two major means of preventing tetanus are immunization and wound care.
There are two types of immunization for any disease -- active and passive. Active immunization is when vaccines are given to a person so that the immune system can make antibodies to kill the infecting germ. In the U.S., health officials recommend active immunization of infants and children with DTaP -- diphtheria, tetanus, and acellular pertussis (whooping cough) -- vaccine at the ages of 2 months, 4 months, 6 months, 12 to 18 months, and again between the ages of 4 and 6. Children should next get a tetanus vaccine using the Tdap vaccine at age 11 or 12. Any adult who has not had a tetanus immunization within 10 years should get a single dose of Tdap. After Tdap, the Td vaccine is recommended every 10 years.
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There is evidence that the tetanus immunization remains highly effective for much longer than 10 years.
When you have a wound, as long as it breaks the skin, it is possible to develop tetanus. Most doctors recommend the following if you have received your primary (active) immunization in the past. If the wound is clean and you have not had a tetanus booster in the last 10 years, it is recommended that you receive one. If the wound is dirty or tetanus-prone, then your doctor would likely recommend a tetanus booster if you have not had a tetanus booster shot within the last five years.
Tetanus-prone wounds are those that are deeper or are contaminated with dirt or soil. If you are unsure about when you received your last tetanus shot, it is better to be safe and receive another booster than sorry. You may experience increased redness and soreness at the injection site if it has been a shorter period of time since your last booster.
If you have never received a primary immunization as a child and you have an open wound, the doctor will likely give you the first vaccine dose at the time of your wound care as well as a single dose of a special immunoglobulin with high activity against tetanus. You must see a doctor in four weeks and again in six months to complete the primary vaccination series.
The second important method of preventing tetanus is cleaning out the wound as thoroughly as possible. Washing the wound with lots of clean water and soap, trying to get any obvious dirt and particulate matter out of the wound are important -- not only to prevent tetanus, but also to prevent other bacterial infections of the wound.
SOURCES: CDC: "Tetanus (Lockjaw) Vaccination." National Network For Immunization Information: "Diphtheria, Tetanus, Pertussis (DTaP)." MedlinePlus: "Tetanus." National Association for Infectious Diseases: "Tetanus (Lockjaw)."