Tetanus is still rare and very rare in children. You can always give the TIG. T alone can still cause reactions such as muscle pain and weakness. Someone here has a farm of some sort and keeps horses and does not do Tetanus.
In the United States, tetanus is primarily a disease of older adults. Persons greater than or equal to 50 years of age now account for over 70% of reported cases. An average of 43 people per year contract Tetanus and there are 0-2 deaths out of a population of 301,139,947 (over 300 MILLION) in the US. (In comparison (FEMA) estimates there are 200 deaths and 750 severe injuries from lightning each year in the U.S.). A Tetanus vax at time of injury is supposed to be a booster to those current on vax and TIG (tetanus immunoglobulin) is for the unvaxed.
From 1992 through 2000 (9 years), 15 cases of tetanus in children <15 years of age were reported from 11 states. Two cases were in neonates <10 days of age;the other 13 cases were in children who ranged in age from 3to 14 years. The median length of hospitalization was 28 days; 8 children required mechanical ventilation. There were no deaths. (I don't have info on their state of health or wound care).
It is not the rust that causes tetanus, so a rusty nail in and of itself is not the issue. Tetanus needs an anaerobic environment to thrive. A wound that has bled is not typically that environment. Keep it clean and covered.
"Keep in mind that the tetanus vaccine became available for widespread civilian use in the late 1940's. Thus tetanus mortality had declined from 205 deaths per 100,000 wounds in the American Civil War (1860) to about .4 deaths per 100,000 population in 1947 at the beginning of widespread civilian use of the vaccine. This means that sanitation, nutrition, year around nutritional improvements, general hygiene, and wound hygiene had reduced the mortality and incidence of tetanus by as much as 99.8 percent before the widespread use of tetanus vaccine." Hilary Butler 89wds
"It should be a rule in all prophylactic work that no harm should ever be unnecessarily inflicted on a healthy person (Sir Graham Wilson, The Hazards of Immunization, 1967)."