A 30-year-old farmer sustains a deep puncture wound contaminated with soil. Records show he received three documented doses of tetanus toxoid in childhood, the last dose 12 years ago. According to standard prophylaxis guidelines, what should be given now?

• A Human tetanus immunoglobulin plus a toxoid booster
• B Full five-dose re-immunisation schedule starting immediately
• C Human tetanus immunoglobulin alone, without toxoid
• D Toxoid booster alone, without immunoglobulin ✓

Explanation

With a complete primary series of three or more doses, circulating memory allows a rapid anamnestic response to a booster, so a tetanus toxoid booster suffices when more than 10 years have passed since the last dose. Human tetanus immunoglobulin is reserved for patients with fewer than three previous doses or unknown status, since passive protection is then required. Repeating the entire primary series is unnecessary in an adequately primed adult.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.