Tetanus shot for lip wound?

[CaliforniaMommy]

My almost 4yo got a pretty deep cut on her lip doing a face plant against the bathroom door jam. It required 6 stitches (2 inside, 4 outside). She isn't vaccinated yet and the docs are pressuring us to give her a tetanus shot, most likely the dtap. They told me at the ER we should do it within 72 hours, which will be in about 12 hours. I'm torn. Any recommendations on this situation?

[ma2two]

Tetanus spores cannot survive when exposed to oxygen. Blood carries oxygen. I imagine a lip wound like that would have bled quite a bit.

There are only about 30 cases of tetanus per year in the U.S., according to the CDC. Most cases are in people over 40 and heroin users.

http://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html

Here are the package inserts for every DTaP vaccine.

http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM101580.pdf

http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM124514.pdf

http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM103037.pdf

[slmommy]

They want high vax rate for DTaP, (especially with pertussis concerns), so they try to use the oppurtunity to get you to vax. As far as I understand, if there was significant tetanus concern - they would give tig, the vax would only be for future, tig for present risk. Do you know which they wanted to give you, or both? I don't think the wound you described would concern me very much in regards to tetanus risk.

[emmy526]

i agree with the other posters as well....sounds to me like they want to up their vax status in the ER as well,  rather than just stitch the lip..how likely is the door jamb  to be contaminated with tetanus spores?  

[Marnica]

I wouldn't do it for the type of wound you described. Bet that bled like crazy. If they are telling you to get the Dtap they must not be too concerned with this wound as the TIG would be given. DTaP would only be "effective" for future wounds of concern, but not this one.

[lokidoki]

Hoping that their pressure did not overwhelm you. Unfortunately they were pressuring you for all their own reasons ~ and not for health reasons for your child or any potential risk for tetanus. A wound that requires stitches like that has to have bled forever...which cleansed the wound, which (as other PPs have said) negates any risk of contracting tetanus.

The vaccination does NOTHING for the current exposure risk ~ isn't effective for at least 14 days AFTER vaccination. So if they were really concerned they would have been apply the pressure for you to have the TIG administered...not the vaccination! But alas...it is all about compliance rates...and getting people to get that pesky pertussis vaccination!