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    Tetanus is completely preventable by active tetanus immunization. Immunization is thought to provide protection for 10 years. Studies of soldiers suggest that good protection persists up to 12 years after the last immunization.

    In the United States, immunizations begin in infancy with the DTaP series of shots. The DTaP vaccine is a "3-in-1" vaccine that protects against diphtheria, pertussis, and tetanus. It is a safer version of an older vaccine known as DTP, which is no longer used in the U.S.

    Td vaccine or Tdap vaccine is used to maintain immunity in those age 11 and older. Tdap vaccine should be given once, prior to age 65, as a substitute for Td for those who have not had Tdap. Td boosters are recommended every 10 years starting at age 19.

    Older teenagers and adults who have sustained injuries, especially puncture-type wounds, should receive booster immunization for tetanus if more than 10 years have passed since the last booster.

    Thorough cleaning of all injuries and wounds and the removal of dead or severely injured tissue (debridement), when appropriate, may reduce the risk of developing tetanus. If you have been injured outside or in any way that makes contact with soil likely, contact your health care provider regarding the possible risk for tetanus.

    Many people believe injuries caused by rusty nails are the most dangerous. This is true only if the nail is dirty as well as rusty, as is usually the case. It is the dirt on the nail, not the rust, that carries the risk for tetanus.


    Reddy P, Bleck TP. Clostridium tetani(Tetanus). In: Mandell GL, Bennett JE, Dolan R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Orlando, FL: Saunders Elsevier; 2009:chap 244.

    Centers for Disease Control and Prevention. 2011 immunization schedules for children 0 to 18 years of age. October 28, 2010.

    Centers for Disease Control and Prevention. Recommended adult immunization schedule United States, 2011 Proposed Revisions, Advisory Committee on Immunization Practices. October 28, 2010.