Tetanus vaccination
October 25, 2010 | 10,00 EUR | answered by Dr. med. Ralf Berg
Hello,
4 days ago, while emptying the dishwasher, I hit a plate on the little finger of my left hand. A skin flap about 0.5 x 0.5 cm in size was torn off directly below the nail. It didn't bleed, just throbbed and burned a little. I didn't pay much attention to it and just sprayed some disinfectant on it, but didn't put a bandage on it. In the evening, I went jogging in the forest and unfortunately fell and landed roughly. I'm not sure if any dirt particles may have gotten into the small wound, I didn't see any. The following two days the area and the surrounding tissue were quite swollen, the finger hurt when touched, I repeatedly disinfected, put on a bandage and wound healing ointment, but it didn't really help. So I just left everything off and now the pain has subsided and a brownish surface has formed.
I received the basic immunization against tetanus as a child and then a booster at the age of 9 because of an accident. After that, I did not receive any more vaccinations, I am now 37 years old. Do I need to get a booster or even a passive vaccination immediately?
Thank you very much!
Dear Questioner,
First of all, a clear statement regarding passive immunization: it is certainly not necessary given the findings shown. According to the latest recommendations, after documented (i.e. proven in the vaccination record) complete primary immunization and a booster vaccination administered within 10 years (as in your case), in the case of minor wounds like yours, you can also do without further active booster shots for tetanus. Previously, a booster shot every 10 years for tetanus was generally recommended, but today it is believed that immunity acquired after regular primary immunization and one booster with currently used vaccines lasts a lifetime. This is a very recent change in the recommended guidelines. Also new is the recommendation for adults who have received pertussis vaccination, i.e. whooping cough vaccination, to receive a booster dose, as this immunity unfortunately does not last a lifetime as previously assumed, and due to good vaccination coverage in childhood and adolescence, the whooping cough pathogen now inevitably targets young adults. While they do not die from whooping cough as infants did in the past, the cough is just as prolonged and unpleasant. And here's the trick: Since this vaccine is only available in Germany as a combination of four (against tetanus, polio, diphtheria, and pertussis), all of these vaccines are refreshed anyway. In conclusion, you don't have to do anything immediately, but you can consider getting all your primary vaccinations refreshed with a single injection from your doctor. The insurance will cover this completely.
A bit confusing, isn't it? But according to the STIKO = Permanent Vaccination Commission, this is the current state of knowledge.
With kind regards, Dr. R. Berg
