Contents

19 Tetanus

Key information

Mode of transmission Environmental exposure to the bacillus, usually through contaminated wounds. The disease is not directly transmitted from person to person.
Incubation period Between 3 and 21 days, commonly about 10 days; may vary from 1 day to several months.
Period of communicability A person with tetanus is not infectious to others.
Burden of disease In older individuals, usually women, who are less likely to have received a primary series of tetanus vaccine.
Funded vaccines DTaP-IPV-HepB/Hib (Infanrix-hexa).

DTaP-IPV (Infanrix-IPV).

Tdap (Boostrix).

Td (ADT Booster).
Funded vaccine indications and schedule 6 weeks, 3 months and 5 months: DTaP-IPV-HepB/Hib.

4 years: DTaP-IPV.

11 years: Tdap.

45 and 65 years: Td.

During pregnancy (from 28 to 38 weeks’ gestation): Tdap.

For individuals with tetanus-prone wounds.

For (re-)vaccination of eligible patients.
Dose interval between Td and Tdap No minimum interval is required between Td and Tdap, unless Tdap is being given as part of the primary immunisation course.
Wound control If an injury is considered to be tetanus prone and there is any doubt about previous tetanus immunisation, the individual must be given tetanus immunoglobulin (TIG) and a 3-dose primary immunisation course.