Tetanus Vaccine and Travel

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The routine schedule for tetanus immunisation for life in the UK is to have 5 doses as per the UK childhood immunisation programme.  If a traveller is visiting a country abroad where treatment for a tetanus prone may not be feasible, then it is advised to give another tetanus containing vaccine prior to departure of this travel trip if there has been an interval of 10 years minimum since the last tetanus vaccine administration.  In the UK, such protection is only currently available in the vaccine 'Revaxis' which is combined tetanus, diphtheria and inactivated polio vaccine. In this instance in an NHS setting, the vaccine used should be purchased in privately if working in England and then claimed back via the Prescription Pricing Authority (PPA).  Stock available for the NHS routine schedule should not be used unless a person has not had their five full doses of vaccine.  Further information regarding routine schedule for tetanus and then further vaccine given for travel purposes can be found in Chapter 30 the Green Book pages 370-373.  Details about ordering these vaccines appropriately is found in Chapter 3 of the Green Book page 20.  

Treatment of a tetanus prone wound

The guidance for the management of patients with tetanus prone wounds was published in 2006 in Chapter 30 of the Green Book, pages 379 - 381, including a table of what constitutes a tetanus prone wound and management that may be required.  Details regarding the supply of tetanus specific immunoglobulin is provided on page 382.  

Of Interest

Six cases of tetanus were reported in England from January to December 2012, there were no reported cases from Wales. All the cases were among adults aged 30 - 82 years.  Two deaths were reported in women over the age of 64 years.  More details are available in the Health Protection Report Volume 7, no 22, published 31st May 2013.  See page 30 of this document or directly here

Further resources for information about tetanus

Public Health England 

NHS Choice 

NaTHNaC