Editing Tetanus (section)

== Prevention ==
Unlike many infectious diseases, recovery from naturally acquired tetanus does not usually result in [[immunity (medical)|immunity]]. This is due to the extreme potency of the tetanospasmin toxin. Tetanospasmin will likely be lethal before it will provoke an immune response.<ref>{{cite web| title = CDC Pink Book Chapter 21: Tetanus| url = https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html| website = CDC.gov| date = August 2021| access-date = 18 March 2023}}</ref>

Tetanus can be prevented by [[vaccination]] with [[tetanus vaccine|tetanus toxoid]].<ref name=MMWR_1991>{{cite journal | title = Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. Recommendations of the Immunization Practices Advisory Committee (ACIP) | journal = MMWR. Recommendations and Reports | volume = 40 | issue = RR-10 | pages = 1–28 | date = August 1991 | pmid = 1865873}}</ref> The [[Centers for Disease Control and Prevention|CDC]] recommends that adults receive a [[Booster shot|booster]] vaccine every ten years,<ref name=CDC2012Pink/> and standard care practice in many places is to give the booster to any person with a puncture wound who is uncertain of when they were last vaccinated, or if they have had fewer than three lifetime doses of the vaccine. The booster may not prevent a potentially fatal case of tetanus from the current wound, however, as it can take up to two weeks for tetanus antibodies to form.<ref name="pmid1574917">{{cite journal | vauthors = Porter JD, Perkin MA, Corbel MJ, Farrington CP, Watkins JT, Begg NT | title = Lack of early antitoxin response to tetanus booster | journal = Vaccine | volume = 10 | issue = 5 | pages = 334–6 | date = 1992 | pmid = 1574917 | doi = 10.1016/0264-410X(92)90373-R }}</ref>

In children under the age of seven, the tetanus vaccine is often administered as a combined vaccine, [[DPT vaccine|DPT/DTaP vaccine]], which also includes vaccines against [[diphtheria]] and [[pertussis]]. For adults and children over seven, the [[DPT_vaccine#Excluding_pertussis|Td vaccine]] (tetanus and diphtheria) or Tdap (tetanus, diphtheria, and acellular pertussis) is commonly used.<ref name=MMWR_1991 />

The [[World Health Organization]] certifies countries as having eliminated maternal or [[neonatal tetanus]]. Certification requires at least two years of rates of less than 1 case per 1,000 live births. In 1998 in [[Uganda]], 3,433 tetanus cases were recorded in newborn babies; of these, 2,403 died. After a major public health effort, Uganda was certified as having eliminated maternal and neonatal tetanus in 2011.<ref>{{cite web |url=http://www.unicef.org/uganda/media_9662.html |title=Uganda announces elimination of Maternal and Neonatal Tetanus |access-date=2011-07-14 |url-status=live |archive-url=https://web.archive.org/web/20150211184728/http://www.unicef.org/uganda/media_9662.html |archive-date=2015-02-11 }}</ref>

===Post-exposure prophylaxis===
Tetanus toxoid can be given in case of suspected exposure to tetanus. In such cases, it can be given with or without tetanus [[immunoglobulin]] (also called ''tetanus antibodies'' or ''tetanus antitoxin''<ref name=britannica2013/>). It can be given as [[intravenous therapy]] or by [[intramuscular injection]].<ref>{{Citation |last1=Rabadi |first1=Thomas |title=Tetanus Toxoid |date=2024 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK557415/ |access-date=2024-06-23 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32491347 |last2=Brady |first2=Mark F.}}</ref>

The guidelines for such events in the United States for people at least 11 years old (and not pregnant) are as follows:<ref name=CDC2012Pink/>

{| class="wikitable"
! Vaccination status !! Clean, minor wounds !! All other wounds
|-
| Unknown or less than 3 doses of tetanus toxoid containing vaccine || [[Tdap]] and recommend catch-up vaccination || [[Tdap]] and recommend catch-up vaccination<br> Tetanus [[immunoglobulin]]
|-
| 3 or more doses of tetanus toxoid-containing vaccine AND less than 5 years since the last dose
|| No indication || No indication
|-
| 3 or more doses of tetanus toxoid-containing vaccine AND 5–10 years since the last dose
|| No indication || Tdap preferred (if not yet received) or [[DPT_vaccine#Excluding_pertussis|Td]]
|-
| 3 or more doses of tetanus toxoid-containing vaccine AND more than 10 years since the last dose
|| Tdap preferred (if not yet received) or [[DPT_vaccine#Excluding_pertussis|Td]] || Tdap preferred (if not yet received) or Td
|}