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The TRAVAX team have just completed a systematic review of tetanus recommendations (October 2011 – February 2012) which has resulted in a change to the way tetanus is listed on the TRAVAX country pages.
Rather than tetanus vaccination appearing as 'Usually Advised' for every country it will now appear under either 'Usually' or 'Sometimes' advised. For both categories of recommendation you are advised to ensure that your traveller has received a full primary course of tetanus vaccine. In addition:
• Usually Advised - travellers should be offered a booster of tetanus vaccine if it has been more than 10 years since their last dose.
• Sometimes Advised - boost travellers who may be unable to access medical facilities promptly in the event of injury if it has been more than 10 years since their last dose.
Tetanus is found worldwide and there is no protective herd immunity afforded through vaccination. The review looked at incidence of disease, including neonatal tetanus cases, vaccine uptake and considered access to appropriate medical services, specifically tetanus immunoglobulin. Countries with a high incidence of tetanus and where access to appropriate treatment was considered problematic were placed in the 'usually' advised category.
In some countries, particularly within Europe, North America, and parts of the Caribbean, where cases of tetanus were rare and most travellers would be able to promptly access appropriate medical facilities in the event of injury routine boosting against tetanus was not considered necessary.
We hope that by trying to better differentiate between countries it will make it easier for you to advise the travellers that you see.
References:
World Health Organization 2011. Immunization, Vaccines and Biologicals. Vaccine preventable diseases. Vaccine monitoring system 2011 at: www.who.int/en/ Accessed October 2011.
World Health Organization 2011. Immunization, Vaccines and Biologicals. Vaccine preventable diseases. Tetanus neonatal reported cases at: www.who.int/en/ Accessed October 2011.
