Guidelines for the management of tetanus-prone wounds Fact sheet August 2021 Check tetanus immunisaon history » Completed primary course 2 Tdap (Boostrix) N.B. If aged 9–10 years OR 11 years immunisaon event due, record this dose as the Schedule Tdap dose on the NIR Not up-to-date with Schedule vaccines Up-to-date with Schedule vaccines No tetanus-containing vaccine dose needed YES NO OR Footnotes 1. For guidance idenfying types of wounds likely to favour the development of tetanus bacteria (tetanus-prone wounds), refer to secon 20.5.6 in the tetanus chapter of the current Immunisaon Handbook. 2. Three doses of tetanus-containing vaccine are required to complete a primary course. If the vaccine course has been interrupted, it may be resumed without repeang prior doses. 3. A tetanus booster vaccinaon is offered at ages 4 years, 11 years in primary care or during year 7 at school, 45 years for adults who have not had four previous tetanus-containing vaccine doses, 65 years, and as part of tetanus-prone wound management. 4. Recommendaons for the use and dosage of tetanus immunoglobulin (TIG) can be found in table 20.2 in the tetanus chapter of the current Immunisaon Handbook. 5. Vaccine choice will be determined by the vaccine recipient’s age at presentaon, the angens required to bring their immunisaon status up-to-date, and for children, parent/caregiver consent for administraon of the required angens/vaccines. Refer to the age-appropriate catch-up table in the Planning immunisaon catch-ups appendix in the current Immunisaon Handbook for guidance. 6. Boostrix is not approved for use as primary immunisaon. However, there are no safety concerns associated with Boostrix use in a primary vaccinaon course. 7. Boostrix may be used for primary immunisaon of children from 7 years of age, adolescents and adults. 8. Boostrix is the only tetanus-containing vaccine available for children from 10 years of age, adolescents and adults. Tetanus- prone wound 1 Less than 5 years since last dose or booster 3 Non-tetanus- prone wound 1 Less than 10 years since last dose or booster 3 Tetanus- prone wounds 1 Wounds that may be contaminated or infected, penetrang, more than six hours old, and with ssue damage. Non-tetanus- prone wounds 1 Wounds that are clean, minor, non-penetrang, less than six hours old, and with negligible ssue damage. » No prior tetanus immunisaon OR » Incomplete primary course 2 OR » Unknown immunisaon status Requires tetanus immunoglobulin 4 (TIG) AND ... Age up to 10 years 5 (i.e., up to the 10th birthday) DTaP-IPV-HepB/Hib (Infanrix-hexa) OR DTaP-IPV (Infanrix-IPV) OR Tdap (Boostrix) 6,7 Age 10 years or older 4 Tdap (Boostrix) 6,8 Requires tetanus vaccinaon Give age appropriate tetanus immunisaon immediately and if needed, arrange addional catch-up immunisaon 5 Non-tetanus- prone wound 1 Tetanus- prone wound 1
Guidelines for the management of tetanus-prone wounds
Jun 20, 2022
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Fact sheet August 2021
Check tetanus immunisation history
» Completed primary course2
Tdap (Boostrix) N.B. If aged 9–10 years OR 11 years
immunisation event due, record this dose as the Schedule Tdap dose on the NIR
Not up-to-date with Schedule vaccines
Up-to-date with Schedule vaccines
YES
NO
OR
Footnotes 1. For guidance identifying types of wounds likely to favour the development of tetanus
bacteria (tetanus-prone wounds), refer to section 20.5.6 in the tetanus chapter of the current Immunisation Handbook.
2. Three doses of tetanus-containing vaccine are required to complete a primary course. If the vaccine course has been interrupted, it may be resumed without repeating prior doses.
3. A tetanus booster vaccination is offered at ages 4 years, 11 years in primary care or during year 7 at school, 45 years for adults who have not had four previous tetanus-containing vaccine doses, 65 years, and as part of tetanus-prone wound management.
4. Recommendations for the use and dosage of tetanus immunoglobulin (TIG) can be found in table 20.2 in the tetanus chapter of the current Immunisation Handbook.
5. Vaccine choice will be determined by the vaccine recipient’s age at presentation, the antigens required to bring their immunisation status up-to-date, and for children, parent/caregiver consent for administration of the required antigens/vaccines. Refer to the age-appropriate catch-up table in the Planning immunisation catch-ups appendix in the current Immunisation Handbook for guidance.
6. Boostrix is not approved for use as primary immunisation. However, there are no safety concerns associated with Boostrix use in a primary vaccination course.
7. Boostrix may be used for primary immunisation of children from 7 years of age, adolescents and adults.
8. Boostrix is the only tetanus-containing vaccine available for children from 10 years of age, adolescents and adults.
Tetanus- prone wound1
booster3
booster3
infected, penetrating, more than six hours old, and with tissue
damage.
Non-tetanus- prone wounds1
Wounds that are clean, minor, non-penetrating, less than six hours old,
and with negligible tissue damage.
» No prior tetanus immunisation OR » Incomplete primary course2 OR » Unknown immunisation status
Requires tetanus immunoglobulin4 (TIG) AND ...
Age up to 10 years5 (i.e., up to the 10th birthday)
DTaP-IPV-HepB/Hib (Infanrix-hexa) OR
DTaP-IPV (Infanrix-IPV) OR
Tdap (Boostrix)6,8
and if needed, arrange additional catch-up immunisation5
Non-tetanus- prone wound1
Tetanus- prone wound1
Check tetanus immunisation history
» Completed primary course2
Tdap (Boostrix) N.B. If aged 9–10 years OR 11 years
immunisation event due, record this dose as the Schedule Tdap dose on the NIR
Not up-to-date with Schedule vaccines
Up-to-date with Schedule vaccines
YES
NO
OR
Footnotes 1. For guidance identifying types of wounds likely to favour the development of tetanus
bacteria (tetanus-prone wounds), refer to section 20.5.6 in the tetanus chapter of the current Immunisation Handbook.
2. Three doses of tetanus-containing vaccine are required to complete a primary course. If the vaccine course has been interrupted, it may be resumed without repeating prior doses.
3. A tetanus booster vaccination is offered at ages 4 years, 11 years in primary care or during year 7 at school, 45 years for adults who have not had four previous tetanus-containing vaccine doses, 65 years, and as part of tetanus-prone wound management.
4. Recommendations for the use and dosage of tetanus immunoglobulin (TIG) can be found in table 20.2 in the tetanus chapter of the current Immunisation Handbook.
5. Vaccine choice will be determined by the vaccine recipient’s age at presentation, the antigens required to bring their immunisation status up-to-date, and for children, parent/caregiver consent for administration of the required antigens/vaccines. Refer to the age-appropriate catch-up table in the Planning immunisation catch-ups appendix in the current Immunisation Handbook for guidance.
6. Boostrix is not approved for use as primary immunisation. However, there are no safety concerns associated with Boostrix use in a primary vaccination course.
7. Boostrix may be used for primary immunisation of children from 7 years of age, adolescents and adults.
8. Boostrix is the only tetanus-containing vaccine available for children from 10 years of age, adolescents and adults.
Tetanus- prone wound1
booster3
booster3
infected, penetrating, more than six hours old, and with tissue
damage.
Non-tetanus- prone wounds1
Wounds that are clean, minor, non-penetrating, less than six hours old,
and with negligible tissue damage.
» No prior tetanus immunisation OR » Incomplete primary course2 OR » Unknown immunisation status
Requires tetanus immunoglobulin4 (TIG) AND ...
Age up to 10 years5 (i.e., up to the 10th birthday)
DTaP-IPV-HepB/Hib (Infanrix-hexa) OR
DTaP-IPV (Infanrix-IPV) OR
Tdap (Boostrix)6,8
and if needed, arrange additional catch-up immunisation5
Non-tetanus- prone wound1
Tetanus- prone wound1
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