What is the recommended vaccination schedule for tetanus prophylaxis in adults and children?

The recommended tetanus vaccination schedule in the UK aims for a full five-dose course to ensure immunity ²,³. Tetanus vaccine is only available as a component of a combined product ²,³.

• Routine Vaccination Schedule:
  • All individuals in the UK should receive tetanus vaccine as part of the routine childhood vaccination programme ²,³.
  • For children over 10 years of age and adults who have not been vaccinated, the schedule includes a primary course of three doses of vaccine (Td/IPV) given one month apart ²,³.
  • This primary course is followed by two booster doses: the first 5–10 years after the last dose of the primary course, and the second 10 years after the first booster ²,³.
• Tetanus Prophylaxis for Wounds:

  An adequate priming course is defined as at least three doses of tetanus vaccine ¹,⁴.

  • For Children Under 5 Years (with adequate priming course):
    • A tetanus vaccine is generally not required for wounds ¹. Continue with the recommended vaccination schedule ¹.
  • For Children Aged 5–10 Years:
    • With adequate priming course and preschool booster: A tetanus vaccine is not required for wounds ¹. Continue with the recommended vaccination schedule ¹.
    • With adequate priming course but no preschool booster:
      • For a clean wound, a tetanus vaccine is not required ¹,⁴.
      • For a tetanus-prone wound, administer an immediate reinforcing dose of the tetanus vaccine ¹,⁴.
      • For a high-risk tetanus-prone wound, administer an immediate reinforcing dose of the tetanus vaccine plus one dose of human tetanus immunoglobulin (HTIG) in a different site ¹,⁴. If HTIG is unavailable in primary care, refer the person to A&E ¹,⁴. Human normal immunoglobulin (HNIG) may be used as an alternative ¹,⁴. Continue with the recommended vaccination schedule ¹,⁴.
  • For People Aged 11 Years and Over (with adequate priming course):
    • Last dose within 10 years: A tetanus vaccine is not required for wounds ¹,⁴. Continue with the recommended vaccination schedule ¹,⁴.
    • Last dose more than 10 years ago:
      • For a clean wound, a tetanus vaccine is not required ¹,⁴.
      • For a tetanus-prone wound, administer an immediate reinforcing dose of the tetanus vaccine ¹,⁴.
      • For a high-risk tetanus-prone wound, administer an immediate reinforcing dose of the tetanus vaccine plus one dose of HTIG in a different site ¹,⁴. If HTIG is unavailable in primary care, refer the person to A&E ¹,⁴. HNIG may be used as an alternative ¹,⁴. Continue with the recommended vaccination schedule ¹,⁴.
  • For People Who Have Not Received an Adequate Priming Course (at least 3 doses) or Immunization Status is Unknown/Uncertain:
    • For a clean wound, administer an immediate reinforcing dose of the tetanus vaccine ¹,⁴.
    • For a tetanus-prone wound or high-risk tetanus-prone wound, administer an immediate reinforcing dose of the tetanus vaccine plus one dose of HTIG in a different site ¹,⁴. If HTIG is unavailable in primary care, refer the person to A&E ¹,⁴. HNIG may be used as an alternative ¹,⁴. A full course of tetanus immunization is likely to be required ⁴. Continue with the recommended vaccination schedule ¹,⁴.