Tetanus, once established in the immune system can often become fatal even with treatment. This is why prevention is the best and most important way of avoiding contraction. Tetanus Vaccination (Immunization) and Wound Care are the two best means of preventing tetanus.

Tetanus Vaccine (Tetanus Toxoid) – Immunization

There are two types of immunization for any disease -- Active and Passive Immunization. Active immunization is the process of administering vaccines to an individual so that the immune system can make antibodies to kill the infecting germ.

The best protection against tetanus is vaccination before exposure. Tetanus vaccines are recommended for people of all ages, pregnant women, or people with immune deficiencies. If a person has tetanus disease or has received a tetanus vaccine before, there is a need to get this vaccine regularly so as to keep a high level of protection against the disease.

There are several types of vaccines that protect against tetanus. These vaccines help protect against tetanus and also provide protection against other diseases:

• DTaP protects against diphtheria, tetanus, and pertussis (whooping cough)
• DT protects against diphtheria and tetanus
• Tdapprotects against tetanus, diphtheria, and pertussis
• Td protects against tetanus and diphtheria

The tetanus vaccine is given to children as part of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). Diphtheria is a serious bacterial infection of the nose and throat. Acellular pertussis, also called whooping cough, is a highly contagious respiratory infection. Children who do not tolerate the pertussis vaccine may receive the alternative vaccine called DT.

Vaccine Administration

• Children younger than 7 years of age should receive either DTaP (Tetanus Toxoid combined with Pertussis and diphtheria vaccine) or pediatric DT (Tetanus Toxoid combined with diphtheria vaccine). Persons 7 years of age or older should receive the adult formulation of Tetanus Toxoid (adult Td), even if they have not completed a series of DTaP or pediatric The use of single-antigen tetanus toxoid is not recommended.
• Tetanus Toxoid should be given in combination with diphtheria toxoid since periodic boosting is needed for both antigens. Two brands of Tdap are available: Boostrix (approved for children 10–18 years of age) and Adacel (approved for persons 11–64 years of age).
• The primary series of 3 doses of DTaP should be given in infancy (age less than 1 year) with a booster dose of a tetanus toxoid-containing vaccine ideally at age 4 to 7 years and another booster in adolescence, e.g., at age 12 to 15 years. The usual schedule is a primary series of four doses at 2, 4, 6, and 15–18 months of The first, second, and third doses of DTaP should be separated by a minimum of 4 weeks. The fourth dose should follow the third dose by no less than 6 months and should not be administered before 12 months of age.
• Because of waning antitoxin titers, most persons have antitoxin levels below the optimal level 10 years after the last dose of DTaP, DTP, DT, or Td., additional booster doses of tetanus and diphtheria Toxoid are required every 10 years to maintain protective antitoxin
• For unvaccinated persons 7 years and older (including persons who cannot document prior vaccination), the primary series is three doses. The first two doses should be separated by at least 4 weeks, and the third dose given 6 to 12 months after the A booster dose of Td should be given every 10 years. Tdap is approved for a single dose at this time. Tetanus disease does not confer immunity because of the very small amount of toxin required to produce illness. Persons recovering from tetanus should begin or complete active immunization with tetanus toxoid (Td) during convalescence.

NOTE: The tetanus toxoid vaccine is an effective, safe, stable, and inexpensive vaccine, and most people who get a tetanus vaccine do not have any serious problems with it. However, side effects can occur. Most side effects are mild and do not affect daily activities.

Wound Care and Management

Once a person gets wounded, as long as there is a break in the skin, it is quite possible to develop tetanus. For persons who might have received active immunization in the past; if the wound is clean and has received a tetanus booster in the last 10 years, it is recommended that another tetanus booster is administered. If the wound is dirty or tetanus-prone, then it is recommended that a tetanus booster is given provided a tetanus booster has not been taken in the past 5 years.

Tetanus-prone wounds are those wounds that are deeper or/and contaminated with soil or dirt, and animal bites. Whenever a person has an open wound and he/she has never received the first immunization as a child, it is possible for doctors to give the patient the first vaccine dose at the time of the wound care as well as a single dose of a special immunoglobin with high activity against tetanus. Then the patient must revisit the doctor after 4 weeks and 6 months to complete the primary vaccination.

Also, cleaning out wounds as thoroughly as possible can prevent tetanus. This can be done with clean water and soap (clean the area around the wound). This would help to prevent any form of bacterial infection of the wound.

For persons with minor wounds especially in home accidents, these steps can help prevent infections:

• Control Bleeding: Apply direct pressure on the wound so as to stop the bleeding
• Clean the Wound: Once the bleeding stops, rinse the wound with a saline solution, bottled, or clear running water.
• Antibiotics Use: Once the wound has been cleansed, apply an antibiotic cream or ointment to the wound so as to prevent bacterial infection and growth.
• Wound Covering: The use of bandages can help to keep wounds clean and prevent dangerous or harmful bacteria from infecting the body. The wound must be covered until a scab form.
• Change the Dressing: Bandages should be replaced at least once a day or whenever the dressing becomes wet or dirty. Rinse the wound, and apply an antibiotic cream or ointment before replacing the bandages.
• Manage Reactions: Some persons are quite allergic to an adhesive that is used in most bandages, if this happens; switch to adhesive-free dressing or sterile gauze and paper tape. If the antibiotics cream or ointment used causes any form of rashes, change to another that does not cause the reaction to the person injured.