About Tetanus

Tetanus is a toxin produced by the bacterium Clostridium tetani (C tetani).1,2 The spores produced by the bacteria cause an acute, life-threatening disease because they are extremely resistant to both heat and many chemical agents that are used to eliminate bacteria.1

Tetanus Remains a Threat to Patients’ Lives

About 10% of those infected with tetanus die.3

For more information, recommendations, and guidelines, visit the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP).

Tetanus infection occurs when1

  • Spores gain access into the body through a wound
  • The spores then germinate and produce toxins

Tetanus-Prone Wounds4

Tetanus-prone wounds are wounds sustained more than 6 hours before surgical treatment or at any point after injury that show 1 or more of the following:

  • Puncture-type wound
  • Significant devitalized tissue
  • Evidence of sepsis
  • Contamination with soil/manure that could contain tetanus organisms
  • Burns
  • Frostbite
  • High-velocity missile wounds

Certain persons are at a higher risk of being infected5-7

  • Immigrants and visitors from other countries
  • Patients born prior to vaccination series being mandatory
  • Intravenous (IV) drug users
  • Patients with diabetes
  • Patients with a history of immunosuppression
  • Patients with chronic wounds

Postexposure Prophylaxis (PEP)

Guide to tetanus prophylaxis in routine wound management8

*Such as, but not limited to, wounds contaminated with dirt, feces, soil, and saliva; puncture wounds; avulsions; and wounds resulting from missiles, crushing, burns, and frostbite.

†DTaP is recommended for children aged <7 years. Tdap is preferred to Td for persons aged ≥11 years who have not previously received Tdap. Persons aged ≥7 years who are not fully immunized against pertussis, tetanus or diphtheria should receive one dose of Tdap for wound management and as part of the catch-up series.

‡Persons with HIV infection or severe immunodeficiency who have contaminated wounds should also receive TIG, regardless of their history of tetanus immunization.

Td, tetanus-and-diphtheria-containing vaccine; TIG, tetanus immune globulin; Tdap, tetanus-reduced-diphtheria-and-pertussis vaccine; DTaP, diphtheria-tetanus-and-pertussis vaccine.

According to CDC surveillance data from 2001 to 2008, an analysis of sufficiently complete case reports of patients with acute wounds who sought medical care revealed that 96% did not receive recommended PEP.2

An animal bite or severe, dirty wound would leave patients at risk for tetanus.9

Access the ACIP guidelines for more information on specific patients.

In patients with an uncertain or incomplete immunization history for tetanus, the vaccine alone is not enough. According to the CDC, the use of a tetanus immune globulin (TIG) may, if promptly administered, reduce the potentially life-threatening risk of tetanus when administered concomitantly with the tetanus vaccine.8

HyperTET, along with wound cleaning and debridement, provides immediate protection. This allows the vaccine the time needed to establish active immunity for your patients in high-risk situations.8,10

Find out which patients are considered high risk.

The Importance of TIG in PEP8,10-12

With a short incubation period of 8 days on average, the rapid immune protection provided by HyperTET is critical for patients who need a TIG

Quick Facts

  • From 2009 through 2017 in the United States, a total of 264 cases were reported with a fatality rate of 7.2%7
  • Almost all reported cases of tetanus are in persons who have never been vaccinated, are inadequately vaccinated, or whose vaccination history is unknown or uncertain8
  • It is possible to get tetanus more than once; people recovering from tetanus should receive the full vaccination series13
Hypermunes Portfolio Information Guide

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Important Safety Information for HyperTET® (tetanus immune globulin [human])

HyperTET® (tetanus immune globulin [human]) is indicated for prophylaxis against tetanus following injury in patients whose immunization is incomplete or uncertain.

HyperTET should be given with caution to patients with a history of prior systemic allergic reactions following the administration of human immunoglobulin preparations.

In patients who have severe thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injections, HyperTET should be given only if the expected benefits outweigh the risks.

Slight soreness at the site of injection and slight temperature elevation may be noted at times. Sensitization to repeated injections of human immunoglobulin is extremely rare. In the course of routine injections of large numbers of persons with immunoglobulin, there have been a few isolated occurrences of angioneurotic edema, nephrotic syndrome, and anaphylactic shock after injection. Administration of live virus vaccines (eg, MMR) should be deferred for approximately 3 months after tetanus immune globulin (human) administration.

HyperTET is made from human plasma. Products made from human plasma may contain infectious agents, such as viruses and theoretically, the Creutzfeldt-Jakob disease (CJD) agent that can cause disease. There is also the possibility that unknown infectious agents may be present in such products.

Please see full Prescribing Information for HyperTET.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

References:

  1. Tiwari TSP, Moro PL, Acosta AM. Tetanus. In: Hall E, Wodi AP, Hamborsky J, et al, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 14th ed. Public Health Foundation; 2021:315-328. Accessed January 17, 2024. https://www.cdc.gov/vaccines/pubs/pinkbook/index.html.
  2. Centers for Disease Control and Prevention. Tetanus surveillance—United States, 2001-2008. MMWR Morb Mortal Wkly Rep. 2011;60(12):365-369.
  3. Centers for Disease Control and Prevention. Diphtheria, tetanus, and pertussis vaccine safety. https://www.cdc.gov/vaccinesafety/vaccines/dtap-tdap-vaccine.html. Updated June 14, 2023. Accessed January 17, 2024.
  4. World Health Organization. Prevention and management of wound infection. https://www.who.int/publications/i/item/prevention-and-management-of-wound-infection. Accessed January 17, 2024.
  5. Alagappan K, Poland GA. Special report: best practices for tetanus vaccination and treatment. A supplement to Infectious Disease Special Edition (IDSE) and Pharmacy Practice News. 2019.
  6. Alagappan K, McGowan J, Declaro D, Ng D, Silverman RA. Tetanus antibody protection among HIV-infected US-born patients and immigrants. Int J Emerg Med. 2008;1(2):123-126.
  7. Blain A, Tiwari TSP. Tetanus. In: Roush SW, Baldy LM, eds. Manual for the Surveillance of Vaccine-Preventable Diseases. February 6, 2020. Accessed November 20, 2023. https://www.cdc.gov/vaccines/pubs/surv-manual/chpt16-tetanus.html.
  8. Llang JL, TiwarI T, Moro P, et al. Prevention of pertussis, tetanus, and diphtheria with vaccines in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2018;67(2):1-44.
  9. Baddour LM, Harper M. Patent education: animal bites (beyond the basics). UpToDate website. https://www.uptodate.com/contents/animal-and-human-bites-beyond-the-basics. Updated February 24, 2022. Accessed January 17, 2024.
  10. HyperTET (tetanus immune globulin [human]) Prescribing Information. Grifols.
  11. Abrahamian FM. Tetanus: an update on an ancient disease. Infect Dis Clin Pract. 2000:9(6):228-235.
  12. Slegrist CA. Vaccine Immunology. In: Plotkin SA, Orensteln WA, Offit PA, eds. Vaccines. 6th ed. China: Saunders; 2013:17-36.
  13. Tetanus fact sheet. World Health Organization. August 24, 2023. Accessed November 21, 2023. https://www.who.int/news-room/fact-sheets/detail/tetanus.