Tetanus Prophylaxis Decision Tree
Cross-reference the CDC's tetanus prophylaxis decision matrix.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Wound type
- Dirty / serious wound
- Tdap / Td immunization status
- Unknown or <3 doses
Result: Td/Tdap: Yes; TIG: Yes
Answer the questions this way to reach that result. Your own answers give your own.
Inputs and output
- What you enter
Two answers: wound type (clean and minor, or dirty and serious), then tetanus immunization history.
- What you get
- The recommended action: Td or Tdap, tetanus immune globulin, both, or neither.
What this is
Cross-reference the CDC's tetanus prophylaxis decision matrix: wound type (clean and minor vs. all other wounds) by immunization history (uncertain or fewer than three prior doses vs. three or more, and time since the last booster). This tool returns the recommended action - no vaccine, Td or Tdap booster, tetanus immune globulin (TIG), or both vaccine and TIG - and notes the CDC preference for Tdap when the patient has never received it, especially in pregnancy and household contacts of infants.
When to use it
Use this in any ED, urgent-care, or primary-care visit for a wound, burn, or animal bite, and at routine adult and pregnancy visits where booster status is being reviewed. The dirty-wound criteria - contamination with dirt, feces, saliva, or soil; puncture wounds; avulsions; crush, burn, frostbite, or missile injuries - matter because they expand the TIG indication. A clean minor wound in a patient with three prior doses and a booster within the last 10 years needs nothing; a dirty wound in an undervaccinated patient may need both Tdap and TIG.
How this is calculated
CDC/ACIP tetanus prophylaxis. Havers FP, Moro PL, et al. Use of Tdap, Td, and tetanus toxoid: ACIP recommendations. MMWR Morb Mortal Wkly Rep. 2020;69(3):77-83. Wound-management table (Td/Tdap and TIG by wound type and vaccination history). Read the source ↗
Source: CDC tetanus prophylaxis decision aid
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.