Does my child need a tetanus shot?
Jeff Wolfrey, MD, is program director of Banner – University Medical Center Phoenix Family Medicine Residency.
Question: My son is 2 1/2 yrs old. Tonight he cut his foot on a nail that was sticking out of a chair. It is just a small scrape. Not a big deal but it did slightly bleed. I put a tiny band-aid and Neosporin on it. I was wondering if he would need a tetanus shot. He is current on all of his shots at this time.
Answer: Your son does not need a tetanus booster for this injury. A child 2-3 years old who is current with his “shots” should have received a total of 4 DTaP immunizations which protect against tetanus, diphtheria, and pertussis (whooping cough). The usual schedule is for these to be given at 2, 4, 6, and 18 months of age. A 5th dose is given in the preschool age range between 4-6 years of age. After this primary series of immunizations protection persists at least 10 years.
The following guidelines apply when deciding whether an injured child needs a dose of tetanus vaccine:
- If a child has received at least 3 doses of vaccine and the last dose is within 5 years additional tetanus toxoid is not needed for any type of wound.
- If less than three doses of vaccine have been received an additional dose should be given for any type of wound. For larger, deeper, puncture, or contaminated wounds human Tetanus Immune Globulin (TIG) should be given in addition to a dose of tetanus toxoid.
- A recent change in tetanus immunization involves the availability of Tdap which is a booster vaccine for older children and adults up to age 64. Tdap protects against tetanus, diphtheria, and pertussis and allows a boost in protection against whooping cough in older individuals. Previously, vaccines against pertussis could only be given up to age 7 and many adolescents and adults became susceptible again to this infection. Tdap should be given instead of the standard Td vaccine at least once for individuals ages 10-64 when they need a tetanus booster in order to gain this additional pertussis protection.