DISASTER INFORMATION
Tetanus Prevention After a Disaster
The risk of tetanus among disaster survivors and emergency responders can best be minimized by following standard immunization recommendations and providing proper wound care.
Key points to remember
Patients without a clear history of at least three tetanus vaccinations who have any wound other than clean and minor NEED tetanus immune globulin (TIG) not just Td.
Tetanus in the United States is most commonly reported in older persons who are less likely to be adequately vaccinated than younger persons. In 2004, 71% of the 34 cases reported were among persons >40 years of age and 47% were among persons >60 years of age.
Older women are especially susceptible; a majority of those > 55 years of age do not have protective levels of tetanus antibody.
Diabetics are at increased risk. Reported tetanus is about 3 times more common in diabetics and fatalities are about 4 times more common.
Non-acute wounds (e.g., chronic ulcers, gangrene, abscesses/cellulitis) account for about 1 in 6 cases of reported tetanus; 1 in 12 reported cases had no reported injury or lesion.
Wound management
| Vaccination history | Clean, minor wounds | All other wounds |
|---|---|---|
| Unknown or < 3 doses | Td or Tdap (Tdap preferred for ages 11-18) | Td or Tdap (Tdap preferred for ages 11-18) PLUS tetanus immune globulin (TIG) |
| 3 or more doses and ≤5 years since last dose | ||
| 3 or more doses and 6-10 years since last dose | Td or Tdap (Tdap preferred for ages 11-18) | |
| 3 or more doses and >10 years since last dose | Td or Tdap (Tdap preferred for ages 11-18) | Td or Tdap (Tdap preferred for ages 11-18) |
| See www.cdc.gov/mmwr/preview/mmwrhtml/00041645.htm. | ||
Routine vaccination
Primary series of diphtheria, tetanus, acellular pertussis (DTaP) in infancy and childhood. (Recommended schedule is 2,4,6, months, 15-18 months, 4-6 years. See www.cdc.gov/nip/recs/child-schedule.htm.
Booster shots of tetanus, diphtheria (Td) or tetanus, diphtheria, acellular pertussis (Tdap) at age 11-12 and then every 10 years. (Tdap is preferred for adolescents 11-18 years of age www.cdc.gov/nip/pr/pr_tdap_jun2005.htm.)
Persons who did not receive DTP or DTaP as a child, or whose tetanus vaccination history is not known should receive a primary series of three doses of adult Td. The first two doses should be separated by 4 weeks and the third dose should follow the second by at least 6 months. For persons 11-64 years of age Tdap may be substituted for ONE of these doses, preferably the first dose. Tdap should be substituted for ONE of these doses for persons 11-18 years of age.
- Page last updated September 9, 2005
- Content source: CDC Emergency Communication System (ECS), Division of Health Communication and Marketing (DHCM), National Center for Health Marketing (NCHM)
Get email updates
To receive email updates about this page, enter your email address:
Contact Us:
- Centers for Disease Control and Prevention
1600 Clifton Rd
Atlanta, GA 30333 - 800-CDC-INFO
(800-232-4636)
TTY: (888) 232-6348
24 Hours/Every Day - cdcinfo@cdc.gov
