In the case of a wound which is likely infected with C. tetani, but before any symptoms have appeared, in addition to wound care and tetanus vaccination, human hyperimmunoglobulins are given intramuscularly, i.e. 250 to 500 IU once only. Hyperimmune horse serum can be used but this sometimes leads to anaphylactic reactions and serum sickness. Tetanus toxoid (toxin inactivated by formalin) is used for vaccination. The vaccine is administered intramuscularly on 3 occasions with a minimum interval of one month between each injection. There is a booster after 1 year and then every 10 years (or after 5 years if injured). It is best if children are vaccinated at the age of 3 months. It is then combined with the vaccinations for whooping cough and diphtheria. A serum antitoxin concentration of 0.01 IU/ml is regarded as protecting against tetanus. This determination can only be carried out in a few laboratories.

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The antibodies (particularly subclass IgG1) cross the placenta from mother to child and protect the neonate from neonatal tetanus. These antibodies gradually disappear from the child’s blood over the following months. Vaccination of the mother is therefore part of the prenatal consultation. The vaccine is very efficient and very safe. It is part of the EPI (extended programme of immunisation) of the WHO.