A 2-year-old child with a deep, dirty laceration from a rusty nail has received 3 doses of DTwP in infancy but no booster doses. The child's last DTwP dose was at 6 months of age. According to standard immunization guidelines, what is the appropriate tetanus prophylaxis?

• A TT booster dose plus tetanus immunoglobulin (TIG) ✓
• B Full course of 3 doses of TT
• C Single dose of tetanus toxoid (TT) only
• D Tetanus immunoglobulin (TIG) only

Explanation

For a dirty wound in a child who received the primary 3-dose series but no booster beyond 6 months of age, and where more than 5 years have elapsed since the last dose, both a TT booster and tetanus immunoglobulin (TIG) are indicated. The child qualifies for TIG because the wound is high-risk (dirty, deep) and adequate booster coverage is absent. Option C would be insufficient for a dirty wound without a recent booster.

Reference: Immunization Handbook for Medical Officers, Government of India, 2017 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.