Merck Manual

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After a Wound: Who Needs a Tetanus Shot?

After a Wound: Who Needs a Tetanus Shot?

Number of Previous Vaccinations

Clean, Minor Wounds

Deep or Dirty Wounds*

Uncertain or fewer than 3†

Tetanus vaccine‡ plus tetanus immune globulin

3 or more§

Tetanus vaccine‡, if it is more than 10 years since the last dose

Tetanus vaccine‡, if it is more than 5 years since the last dose

* Included are wounds contaminated with dirt, stool, soil, or saliva, as well as puncture wounds, wounds involving loss of tissue, wounds caused by a penetrating object or crushing, burns, and frostbite.

† People who have not been given the recommended number of tetanus vaccine doses are advised to get them (called catch-up vaccination).

‡ Which form of the tetanus vaccine is used depends on the person’s age. For people 7 years old or older, tetanus and diphtheria toxoid (Td) vaccine is used. Tetanus, diphtheria, and acellular pertussis (Tdap) is preferred to Td for adults who have never been given Tdap. Children younger than 7 years old are given diphtheria, tetanus, and acellular pertussis (DTaP) vaccine. Children who cannot be given pertussis vaccine (for example, those who have a seizure or certain other brain or nerve disorders) are given diphtheria and tetanus (DT) vaccine.

§ If only three injections of tetanus vaccine have been received, a fourth dose should be given.