Tetanus vaccination

Marian Grosser studied human medicine in Munich. In addition, the doctor, who was interested in many things, dared to make some exciting detours: studying philosophy and art history, working on the radio and, finally, also for a Netdoctor.

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The tetanus vaccination is the most effective remedy for tetanus (tetanus) if regularly refreshed. This infectious disease can be associated with significant complications and, if left untreated, fatal. Here you can find out the most important information about the “tetanus vaccination”.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. A34A33Z27A35

How does the tetanus vaccination work?

Tetanus is caused by the bacterium Clostridium tetani, more precisely by its poison. The pathogen enters the human body through small or large wounds and produces two toxins (bacterial poisons) there. One of them, tetanospasmin, is responsible for the typical symptoms of tetanus. The real danger is not the bacteria themselves, but their tetanus poison.

The active tetanus vaccination

This is exactly where the active tetanus vaccine comes in. In principle, this is the bacterial toxin itself, albeit in a weakened form. Doctors then speak of the tetanus toxoid. If the patient is injected in this state, his immune system comes into contact with the "light version" of the poison and begins to form antibodies against it.

Because the injected poison is weakened ("detoxified"), it does not cause disease. Rather, the tetanus vaccine creates effective immune protection against the infectious disease. If the dangerous pathogen is actually infected later, the immune system can react quickly and fight off the tetanus pathogen. The vaccinated person is therefore immune and can usually no longer fall ill.

Vaccinations, in which the body's own production of antibodies is stimulated, are called active vaccinations. Since no living bacteria are injected with the active tetanus vaccination, it is also known as a dead vaccination.

The vaccination against tetanus contains the "detoxified" pathogen (toxoid), which is why one speaks of a toxoid vaccine.

The passive tetanus vaccination

In contrast to active vaccinations, with passive vaccinations, the doctor injects ready-made antibodies that are directed against tetanospasmin. These so-called tetanus immunoglobulins (tetanus antitoxin) are obtained from human blood. They are used when the patient has an open injury but no active vaccination is available. If those affected then receive the passive tetanus vaccine, this can prevent the symptoms of tetanus or at least significantly alleviate them.

Every tetanus vaccination, whether passive or active, is injected into a muscle (intramuscularly, IM), either on the upper arm or on the thigh. In the case of an open wound, doctors also give the passive tetanus immunization to the muscles at the edges of the wound.

Tetanus vaccination: when and how often?

The Standing Vaccination Commission (STIKO) recommends an active tetanus vaccination expressly for people of all ages. In principle you can vaccinate at any time, with the exception of serious illnesses and high fever. Because under these circumstances the immune system is weakened or already so busy that it may not be able to build up adequate immune protection against the tetanus poison. However, a mild cold is not an obstacle to vaccination, as is often wrongly assumed.

When is the first tetanus vaccination available?

First the so-called basic immunization takes place. It begins in early infancy. The doctor usually gives the tetanus vaccine along with other standard vaccinations for diphtheria, polio, whooping cough, hepatitis B and the Haemophilus influenzae type b vaccine (Hib). For this so-called six-fold vaccination, the STIKO experts currently recommend a 2 + 1 vaccination scheme - as a total of three vaccinations:

From the 2nd month of life, doctors inject the first tetanus vaccination (or six-fold vaccination)
At 4 months of age, children receive the second dose of vaccine
In the 11th month of life, the basic immunization ends with the third vaccination against tetanus

Not all vaccines are approved for the reduced 2 + 1 vaccination schedule. If only these are available, doctors will administer the vaccination four times (in months of life 2, 3, 4 and 11)!

Premature babies (born before the 37th week of pregnancy) always receive four tetanus vaccinations (3 + 1 vaccination schedule). In addition to the above-mentioned vaccination appointments, the doctor injects the vaccine against tetanus an additional time in the third month of life - also as part of a six-fold vaccination.

Tetanus catch-up vaccination

If a tetanus vaccination is missed in childhood, it can be made up for adults at any time. It even makes sense to vaccinate even if there is a suspicion of tetanus infection. This usually happens together with a passive vaccination. If you do not know whether you were vaccinated as a child, the experts recommend a complete basic series - also with three tetanus vaccine doses.

A tetanus illness does not provide lasting immune protection! The tetanus vaccination is therefore still important for people who have already had tetanus.

Tetanus: don't forget to refresh!

The basic immunization leads to the formation of antibodies, but must be refreshed at regular intervals. If the tetanus vaccination was given in infancy, the vaccination protection is refreshed with one injection each between the ages of 5 and 6 and between the ages of 9 and 16. In order to receive vaccination protection, adults also have to be re-vaccinated every ten years.

Diphtheria, whooping cough and tetanus: booster vaccination in a collective package

The refresher at the age of 5 takes place in combination with the diphtheria vaccination and whooping cough vaccination. The next booster for teenagers is given by doctors as a quadruple vaccination against tetanus, diphtheria, polio and whooping cough.

For adults, the combined tetanus-diphtheria vaccination (Td vaccination) is best suited to refresh the vaccination protection every ten years. However, the STIKO experts advise that adults receive the triple combination vaccine tetanus-diphtheria-whooping cough (Tdap vaccination) once.

A single vaccination dose is sufficient for a tetanus booster, even if the last vaccination was more than ten years ago. The vaccination protection is very reliable. You do not have to keep time intervals to other vaccinations.

Tetanus vaccination: side effects

As with many other medicines, they also come with the tetanus vaccine: side effects. However, these are rather rare and in the vast majority of cases harmless. The most common side effects include:

Temporary discomfort in the gastrointestinal area (nausea, diarrhea)
headache
fever
Swelling, redness and pain at the injection site

Allergic reactions such as itchy pustules are less common. In very few cases, severe allergic symptoms including circulatory shock have been described. The latter is not specific for the tetanus vaccination, side effects of this kind can occur with any type of vaccination.

Does a tetanus vaccination really make sense?

Widespread worldwide, tetanus is rather rare in Germany. Reasons include the good living conditions and hygienic conditions, but above all a high tetanus vaccination rate. But even in this country, deaths occur again and again despite the good medical care. With the widespread vaccination, the number of cases has continued to decline - for comparison: before 1970 there were well over 100 tetanus cases. Since the pathogen can occur almost anywhere, the tetanus vaccination remains the only way to effectively protect yourself against infection.

Tetanus vaccination for injuries

How doctors vaccinate a wound depends, on the one hand, on the vaccination status of the person concerned. On the other hand, the wound conditions play a role. The following applies to clean and minor injuries:

People without a tetanus vaccination or if the vaccination status is unclear: simultaneous tetanus vaccination, i.e. vaccination with both an active tetanus vaccine and a passive immunization
People with an incomplete vaccination series or the last tetanus booster vaccination more than ten years ago: Only active immunization
People with at least three doses or a booster within the last ten years: No tetanus vaccination necessary

In the case of deeper and / or soiled injuries, different recommendations apply. They also affect patients who, for example, have poor blood circulation or are weakened by the immune system:

People without a tetanus vaccination, with an unclear vaccination status or less than three previous vaccinations: Simultaneous vaccination (active + passive tetanus vaccination)
People with at least three vaccinations and a booster in the last five years: No vaccination required
People with at least three vaccinations and a booster that was more than five years ago: Active tetanus vaccination

With simultaneous vaccination, doctors inject passive and active immunization into different muscles. The tetanus vaccinations take place either in the form of combination vaccines (plus diphtheria, pertussis) or alternatively with a vaccine only against tetanus.

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