UK schedule is for 3 tetanus containing vaccines in first year of life, followed by extra dose of 6 in 1 at 18 months (new from July 2025). First real booster is pre-school (3 years 4 months). Second booster is at 10 years after 1st course, routine is for Td/IPV at 14.

Incubation period is 4-21 days.

Tetanus prone wounds

• Puncture in soil contaminated environment
• Wounds containing foreign bodies
• Compound fractures
• Wounds/burns with systemic sepsis
• Some animal bites/scratches

Not exclusive. Animal bites/scratches depends on whether there would have been soil in the mouth/claw…

High risk wounds on the other hand include heavy contamination with soil/manure, wounds/burns with extensive devitalised tissue, delayed surgical intervention beyond 6 hours even if not high risk initially.

Management of Wounds

If within 5 years of last vaccine (and complete primary course) – so up to 8 years old, likely good antibody levels so no booster required. If more than 5 years since immunisation, then giving booster vaccine is as effective as giving Tetanus immunoglobulin (TIG) so save it for high risk wounds only.