Tetanus immunization is achieved with tetanus toxoid (inactivated toxin)
and NOT with attenuated bacteria. The vaccine is thus extremely safe and
has little side effects. The toxoid is so highly immunogenic that it is
even used as an adjuvant/carrier for other vaccines (like e.g. some H.
influenzae type b capsular polysaccharide vaccines). Tetanus is a
devastating disease, thus, even if it is rare in industrialized countries
complete immunization is highly recommended and booster doses should be
administerd during management of wounds. In developing countries neonatal
tetanus is claiming the lives of many newborns, and WHO is therefore
actively promoting vaccination efforts in disadvantaged regions. For a
reference have a look at any textbook (Control of Communicable Diseases
in Man by A.S.Benenson, 15th Ed. 1990 is very concise) or refer to the
regularly updated ACIP recommendations on immunizations published by the
CDC, Atlanta (MMWR series; or check www.cdc.gov).
--
Andre P. Burnens MD
Institute for Veterinary Bacteriology, University of Berne
Laenggass-Strasse 122, CH-3012 Berne, Switzerland
Tel. +41 31 631 24 85 Fax. +41 31 631 26 34
