Ask an Expert: Tetanus risk, if innoculation is out of date

Infectious Diseases

Tetanus risk, if innoculation is out of date
10/01/2004

Question:

Cuts while outdoors aren`t rare. If a tetanus innoculation is out of date, when should someone be concerned enough to go the hospital? As long as the wound is cleaned with soap soon after the injury, should you wait for a few days to see if an infection develops? Is the answer different, depending on the age of the individual? Thanks.

Answer:

A person with a documented series of three Td (tetanus/diphtheria) doses who has received a booster dose within the last ten years is most likely protected. To ensure adequate protection, a booster dose of vaccine may still be given if it has been more than five years since the last dose and the wound is other than clean and minor.Tetanus bacilli live in the soil, so the most dangerous kind of injury involves possible contamination with dirt, animal feces, and manure.
Although we have traditionally worried about deep puncture wounds, in reality many types of injuries can allow tetanus bacilli to enter the body. In recent years, more cases have had minor wounds than had major ones, because severe wounds were more likely to be taken care of in a hospital. Reported infections with tetanus have occurred following surgery, burns, lacerations, abrasions, crush wounds, ear infections, dental infections, animal bites, abortion, pregnancy, body piercing and tattooing, and injection drug use. It would not be prudent to wait until a wound is infected. It is best in any case to contact your primary care MD to help evaluate the risk of infection.
source: http://www.vaccineinformation.org/tetanus/qandadis.asp

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Response by:

Benita Jackson, MD, MPH, FACPM
Assistant Professor, Epidemiology
College of Public Health
The Ohio State University