Child's immunizations include tetanus


August 10, 1993|By Dr. Modena Wilson and Dr. Alain Joffe | Dr. Modena Wilson and Dr. Alain Joffe,Contributing Writers

Q: Last week, my 17-year-old son stepped on a nail or something that went through his sneaker and slightly punctured the bottom of his foot. Our doctor said there was no need to give him a tetanus shot. Why?

A: Without knowing all the details of your son's medical history, we canonly guess as to why your son's physician reached such a conclusion. Children usually get a primary tetanus immunization series during the first year of life with boosters at 18 months and again at 5 years. Then the schedule switches to a booster dose at 10-year intervals throughout life.

If your son had his regularly scheduled tetanus shot at 15, then he is well protected and no further immunization is needed, even with a puncture wound.

What occurred with your son is an excellent example of why keeping careful records of childhood immunization is important.

Too often, individuals who suffer some kind of penetrating wound are unaware of their tetanus status and hence receive multiple tetanus shots close together during adolescence and adulthood. Such a practice increases the likelihood of local reactions that can result in a large degree of tissue swelling, pain

and redness.

Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

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