Active vaccination
Tetanus vaccination (tetanus) is a standard vaccination (regular vaccination) given by means of an inactivated vaccine. In this process, the administration of the toxin stimulates the body to produce antibodies (defense cells), which then enable immunity (protection) against this disease. The following are the recommendations of the Standing Commission on Vaccination (STIKO) at the Robert Koch Institute:
Indications (areas of application)
- S/A: All persons with absent or incomplete basic immunization, if the last vaccination of the basic immunization or the last booster vaccination was given more than 10 years ago
Legend
- S: Standard vaccinations with general application.
- A: booster vaccinations
Implementation
- Basic immunization: three vaccine doses at 2, 4, and 11 months of age are recommended for basic immunization of mature infants.For preterm infants (born before the completed 37th week of gestation), 4 vaccine doses at chronological ages of 2, 3, 4, and 11 months are recommended.
- Today there is a possibility of carrying out combination vaccinations, so that children are effectively protected against infectious diseases with relatively few vaccinations. The six-vaccination schedule protects against diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae type b, and hepatitis B. The current reduced “2+1 schedule” for the six-vaccination schedule is as follows: At 8 weeks of age, the vaccination series is started and subsequent vaccinations are given at the recommended times at 4 and 11 months of age. Between the 2nd and 3rd vaccination doses, a minimum interval of 6 months must be observed.
- Repeat vaccination: age 15-23 months and 2-4 years.
- The first booster vaccination is administered at 5-6 years of age. Another booster vaccination is recommended at 9-17 years of age.
- From the seventh year of life is usually administered a combination of a tetanus and a diphtheria vaccine (Tdap combination vaccination, if indicated as Tdap-IPV combination vaccination).
- In individuals with a lack of vaccination protection, basic immunization consists of three doses administered within one year.
- In persons with insufficient vaccination protection or if the last booster vaccination is more than ten years ago must be revaccinated.
- Adequate vaccination protection is particularly important for the elderly or people with chronic diseases such as diabetes mellitus, skin diseases.
Booster
- One dose once every 10 years (preferably using the Td combination/tetanus-diphtheria-absorbate vaccine).
Efficacy
- Reliable efficacy (exception: immunimcompetence).
- Onset of efficacy about 2 weeks after the second dose.
- Duration of efficacy
Contraindications
- Persons with acute diseases requiring treatment.
- Individuals who showed intolerance to a previous vaccination with the vaccine in question
- Allergy to vaccine components (see manufacturer’s supplements).
Possible side effects/vaccine reactions
- Very often mild local reaction (rarely more severe local reaction, usually in hyperimmunization).
- Allergic skin and general reactions (rare to very rare).
Passive vaccination
Passive tetanus vaccination involves direct injection of antibodies that the body must produce itself during active vaccination. Depending on the type of wound (clean or dirty) and tetanus vaccination status (number of vaccinations), a simple (active vaccination only) or simultaneous vaccination (active and passive immunization together) is performed.
| Number of tetanus vaccine doses to date. | Clean, minor woundsvaccine required | Clean, minor woundsimmunoglobulin required | Deep/soiled woundsvaccine required | Deep/soiled woundsimmunoglobulin required |
| Unknown | Yes | No | Yes | Yes |
| 0-1 | Yes | No | Yes | Yes |
| 2 | Yes | No | Yes | No (if miracle not older than 24 h) |
| ≥ 3 | No (if last vaccination < 10 years) | No | No (if last vaccination < 5 years) | No |
Vaccination status – checking vaccination titers
| Vaccination | Laboratory parameters | Value | Rating |
| Tetanus(tetanus) | Tetanus IgG ELISA | <0.1 U/ml | No sufficient vaccination protection detectable → basic immunization required |
| 0.1-0.2 U/ml | Questionable vaccination protection → booster recommended | ||
| > 0.2 U/ml | Sufficient vaccination protection (→ control in 3 years). |
