A little history
For many years I've said once you have had 5 doses of tetanus containing vaccine then you are protected for life within the UK. Information written in the Green Book chapter on tetanus published in 2005 and 2007 indicated that if you then sustained a tetanus prone you would require treatment which would be tetanus-specific immunoglobulin but such documents are not available online any more.
The Patient Info website on their page here states:
The primary course of three injections gives good protection for a number of years. The fourth and fifth doses (boosters) maintain protection. After the fifth dose, immunity remains for life and you do not need any further boosters (apart from some travel situations).
We would however, administer more tetanus containing vaccine (in excess of the 5 doses) if someone was travelling to an area where there is risk and it may not be possible to secure treatment for a tetanus prone wound. In this situation, we would continue to give a tetanus containing vaccine (Revaxis) every 10 years if needed.
New guidance
However new guidelines published by PHE on 9 November 2018 entitled Tetanus: advice for health professional Guidance on the treatment of tetanus cases and management of tetanus prone wounds leads me to think the limit of 5 doses is not necessarily the case any longer. The Green Book chapter 30 for tetanus was also updated on 26 November 2018 and provides a more comprehensive perspective of what is a 'tetanus prone wound'.
The table for treatment (page 11) then outlines who should receive treatment and this indicates that even those born after 1961 (when tetanus came into the national immunisation programme) with a history of accepting vaccines (which to my mind means they should have had all five doses) would still have a further dose of tetanus if they sustained a tetanus prone injury and possibly if it was more than 10 years since their last tetanus containing vaccine - but this doesn't actually seem to be stated.
I'm trying to get this verified and will post further information here when I do. Meanwhile I've highlighted the sections of the table by adding extra comments, which lead me to think this - see below, but if you have a patient in this situation, please always check these resources thoroughly yourself.
