- In children, primary immunization against tetanus is usually done in conjunction with diphtheria and pertussis vaccination using DTaP or a combination vaccine that includes hepatitis B and polio vaccines. A 0.5-mL dose is recommended at 2, 4, 6, and 15 to 18 months of age.
- Additional doses of tetanus toxoid are recommended as part of traumatic wound management if a patient has not received a dose of tetanus toxoid within the preceding 5 years (Table Tetanus Prophylaxis).
- In adults or children older than 7 years of age where primary immunization against tetanus alone is needed, a series of three doses of Td is administered intramuscularly; the initial dose is followed by a repeat dose in 1 to 2 months, then the third at 6 to 12 months after the first dose. Boosters are recommended every 10 years.
- Tetanus toxoid may be given to immunosuppressed patients if indicated.
- Tetanus immune globulin is used to provide passive tetanus immunization following the occurrence of traumatic wounds in nonimmunized or suboptimally immunized persons (see Table Tetanus Prophylaxis). A dose of 250 to 500 units is administered intramuscularly. When administered with tetanus toxoid, separate sites for administration should be used.
| TABLE. Tetanus Prophylaxis | |||||||||||||||||||||||||
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| TABLE. H. influenzae Type b Conjugate Vaccine Products | |||||||||||||||||||||||||
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- Tetanus immune globulin is also used for the treatment of tetanus. In this setting, a single dose of 3000 to 6000 units is administered intramuscularly.