Tetanus Prophylaxis

History of Tetanus Immunization (doses)	Clean Minor Wounds		All Other Wounds^c
History of Tetanus Immunization (doses)	Tetanus Toxoid^a	Tetanus Immune Globulin^b	Tetanus Toxoid	Tetanus Immune Globulin^b
Unknown or if <3 doses in a vaccine series	Yes	No	Yes	Yes
3 or more doses in a vaccine series and <5 y since last booster dose	No	No	No	No
3 or more doses in a vaccine series and between 5 and 10 y since last booster dose	No	No	Yes	No^d
3 or more doses and >10 y since last booster dose	Yes	No	Yes	No

Note: Tetanus immune globulin prophylaxis recommended for dirty/major wounds if the patient is severely immunocompromised or HIV positive.

a Dose of tetanus toxoid is 0.5 mL intramuscularly.

b Dose of tetanus immune globulin is 250 IU intramuscularly.

c Such as, but not limited to, wounds contaminated with dirt, feces, soil, and saliva; puncture wounds; avulsions; and wounds resulting from missiles, crushing, burns, and frostbite.

d Unless wound is >24 hours old.

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Appendix A.2