Tetanus Vaccines

00:00
09:48
Sign in or subscribe to listen

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Nurses Edition Commentary

Kathy Garvin, RN and Lisa Chavez, RN
00:00
01:35

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Heather H. -

On tetanus convo. I’ve run into a few times, a kid w no prior vaccinations w a lac that I’ve gotten mom to agree to tetanus (🤷🏼‍♀️ But 🥳). We don’t carry Dtap in the ED, should I just give Tdap? UpToDate says Td or Dtap for under 7 if I remember right. I’ve never gotten an answer to that. And if I can vaccinate a kid w some sneaky extra vaccines I’m all in. Also is there utility to a single vaccine in this situation or do I need to get them to also agree for followup boosters to make it worth it.

Catherine M. -

The CDC now recommends tetanus for all wounds if last vaccination was more than 5 years ago.

https://www.cdc.gov/tetanus/clinicians.html

If the last dose of a tetanus toxoid-containing vaccine was received 5 or more years earlier, then administer a booster dose of an age-appropriate tetanus toxoid-containing vaccine.

David W. -

I am not sure whether I agree with this segment about giving Tdap in the ED because of the added pertussis protection. Here's the ACIP/CDC recommendations: https://www.cdc.gov/mmwr/volumes/67/rr/rr6702a1.htm

No Additional Doses of Tdap for the General Population

...Clinical trials support that a second dose of Tdap is safe and immunogenic at a 5- or 10-year interval (184–188). Immunogenicity studies show that diphtheria and tetanus antibody levels persisted for five to 10 years after receipt of Tdap (186,188,262,263,297–301). However, antipertussis antibodies decline rapidly after the first year, suggesting that protection wanes, which would likely limit the impact of a second dose of Tdap on the overall burden of pertussis in the United States (186,188,262,263,297–301). Antibody decay and, therefore, clinical protection following additional doses of Tdap are likely similar to what is observed following the first dose of Tdap.

Anand S., M.D. -

David - excellent points. We focused more on the tetanus piece of this but, we need to give pertussis a bit more attention. We'll get Isaac back on to discuss all of this. Thanks!

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.

To download files, you need to subscribe.

Sign up today for full access to all episodes.
EM:RAP 2021 February Full episode audio for MD edition 214:23 min - 229 MB - M4AEMRAP 2021 February PA Edition PA Edition 60:19 min - 83 MB - MP3EM:RAP 2021 February German Edition Deutsche 97:11 min - 134 MB - MP3EM:RAP 2021 February Canadian Edition Canadian 16:19 min - 23 MB - MP3EMRAP 2021 February Farsi Edition Farsi 191:42 min - 263 MB - MP3EMRAP 2021 February Spanish Edition Español 43:32 min - 60 MB - MP3EMRAP 2021 February French Edition Français 23:52 min - 33 MB - MP3EMRAP 2021 February Aussie Edition Australian 0:49 min - 1 MB - MP3EM:RAP 2021 02 February Written Summary 604 KB - PDFEM:RAP 2021 February Board Review Answers 152 KB - PDFEM:RAP 2021 February Board Review Questions 109 KB - PDFEM:RAP 2021 February MP3 Files 245 MB - ZIP

To earn CME for this chapter, you need to subscribe.

Sign up today for full access to all episodes and earn CME.

6 AMA PRA Category 1 Credits™ certified by CEME (EM:RAP)

  1. Complete Quiz
  2. Complete Evaluation
  3. Print Certificate