Prevention

The majority of all adult types of tetanus cases can be prevented by active immunization; neonatal cases are prevented by good hygiene and careful, sterile technique used to sever the umbilical cord and later (at 2 months old), beginning active immunizations. There are two main vaccines recommended by the U.S. Centers for Disease Control and Prevention (CDC). For pediatric populations, DTaP (diphtheria, tetanus and acellular pertussis combination vaccine) is used. For non-immunized adults and booster shots, Tdap (tetanus and reduced amounts of diphtheria and acellular pertussis combination vaccine) is recommended. Tdap was recommended (by the CDC in 2005) over the older Td combination vaccine, as cases of pertussis (whooping cough) had been increasing in the last decade.

• All partially immunized as well as unimmunized adults should receive a tetanus vaccination (see below).



• The initial series for non-immunized adults involves three doses of Tdap:
  
  
  • The first and second doses are given four to eight weeks apart.
  
  
  
  • The third dose is given six months after the second.
  
  
  
  • Booster doses are required every 10 years after that.
  
  
• In children, the immunization schedule calls for five doses of DTaP.
  
  
  • One dose is given at 2, 4, 6, and 15-18 months of age.
  
  
  
  • This DTaP series is completed with a final dose when the child is between 4-6 years of age.
  
  
  
  • Additional boosters with Tdap are given every 10 years after the final DTaP dose. Children that miss doses of DTaP can be given Tdap doses, but the choice for dose schedule should be determined by the patients' doctor.

People who are not completely immunized and have a tetanus-prone wound should receive a tetanus booster in addition to tetanus antibodies (human tetanus immune globulin or TIG). The tetanus antibodies (TIG) will provide short-term protection against the disease. For patients sensitive to the combined vaccines (DTaP or Tdap), other vaccines against tetanus are available (for example, Td), but the patients' doctor should determine the dosage schedule.

• Vaccine shots are somewhat painful (pain likely due to multiple factors such as inserting foreign material into a muscle, spreading out muscle fibers to make room for vaccine volume, the body's immune response, and others), but that pain should never prevent people from getting either immunized or booster shots. In most cases, the pain does not last long.