i declined a tetenus shot today but

[Kailey's mom]

now that ER doc has me scared, and even said i could end up on a resperator because i wont be able to breath. I cut my finger this morning, got 6 stitches. She said i have 72 hours to make the choice, she told me all the research i have done on vaccines were not true, and she would hate to see me in the icu, i am pissed and now a little worried also. any info would we great

[listipton]

I don't have any links for you...but what did you cut your finger on? Unless it was something that comes into contact with soil on a regular basis, I wouldn't worry too much.

[ammiga]

Did your wound bleed? Did they clean it before they sealed it up? If the answer to those is yes, I wouldn't worry in the slightest.

Dd went to the ER to get stitches a few months ago. She needed 5. No one even mentioned getting tetanus, and I was honest when they asked if she was UTD on vaccines (she's never had any).

[Emmeline II]

Originally Posted by ammiga

Did your wound bleed? Did they clean it before they sealed it up? If the answer to those is yes, I wouldn't worry in the slightest.

[rainbowmoon]

That is totally NOT true about only being exposed to tetanus if the item was in contact with soil. Tetanus also lives on your skin. My grandma got it from popping a pimple on her arm about 35 years ago and she was never near soil, farms or horses (she lived in the city and is not an outdoor person). She developed lock jaw and was very sick for many months but made a full recovery.

I think the dr. is just trying to cover their ass IMHO. Don't worry. You'll be fine. Just keep an eye out for fever as that would be the first sign. My grandma would have recovered faster had she not ignored the warning signs. she didn't get medical tx until the lockjaw set in though.

[jeanine123]

A PLAIN tetanus shot won't do you much good after the fact. What you would need, if you were so inclined, is the tetanus immunoglobulin. Though honestly, I think the dr was using scare tactics on you. When I cut my finger on a piece of glass and went for stitches at the ER nobody said boo to me about a tetanus shot.

[crunchy_mommy]

Maybe I'm missing something but don't you need an antibody response for a vaccine to be effective? And it takes at least several days for sufficient antibody levels to develop? So how would giving a shot after you've already (possibly) been exposed do any good??

[mamadelbosque]

Yeah, if it were a real tetanus risk they'd have offered/pushed TIG - tetanus immunoglobin. But they almost never do, cause' almost all the things they push tetanus for aren't really tetanus risks. Yes. In theory, you can get tetanus from absolutely any little scratch or scrape or busted lip. But in practice its very, very rare as long as you keep your cuts/wounds fairly clean.

[xmasbaby7]

Absolutely a scare tactic.

Vaccines are NOT emergency medicine.

Crazy that this is an ER norm now. I had a puncture wound last summer that developed a staph infection and when they pushed the tetanus vax on me, they were insistent that it would protect me from tetanus.

[JamieCatheryn]

Aren't the odds of developing lockjaw mostly high if you have poor circulation, especially older people or those with diabetes? And in wounds that don't bleed much or get exposed to air, like puncture wounds? Tetanus is everywhere but it rarely gets anyone sick who is otherwise healthy.

[Fyrestorm]

The tetanus vaccine can take up to two weeks for an immune response.

As PPs have stated, if it was actually a concern, they would be pushing the TiG, not the vaccine. The vaccine is useless after an injury.

[Kailey's mom]

thanks for all the great feedback!! i am now convinced it was a scare tactic, and that was pretty messed up that the doc pushed so hard

[SanJosemama]

Rule of thumb: If they say you need a tetanus vaccine, you don't. If they say you need the TIG, there's a possibility you might.

[laohaire]

I read on MDC *all the time* about docs pushing tetanus shots in the ER after a cut or puncture.

I have to wonder, given the obvious problems with that - do you think they actually do mean the TiG? And just saying "tetanus shot" or "tetanus vaccine" because they think their patients are too dumb to understand what they mean?

The alternatives that I can think of are:

1) They are fully aware that the tetanus vaccine won't do diddly, and they are not at all concerned about tetanus for this injury, but just scaring people into doing it (like, "oh, this was a close call, may as well get it now so you don't have to worry next time"). Of course you have to wonder why it's such a big thing for them, are ER docs getting kickbacks or something?

2) They were actually taught in medical school that the tetanus vaccine (and not TiG) is appropriate for post-injury care.

[crunchy_mommy]

Originally Posted by laohaire

2) They were actually taught in medical school that the tetanus vaccine (and not TiG) is appropriate for post-injury care.

I am guessing this one... which is pretty scary.

I was reading the prescribing info on one of the vaxes (one brand of dtap i believe) and there was a whole section about "wound management" and how the vax should be given for certain wounds. There was a whole chart about wound type & vax status & which situations 'require' the vax.

ETA: here is is, it was a Td vax, Decavac, pages 11-12:
http://www.fda.gov/downloads/Biologi.../UCM142638.pdf