AC-toxoid injected deep subcutaneously in the subscapular region in a dose of 0.5 ml.Before vaccination, the ampoule must be shaken thoroughly until a homogeneous suspension is obtained.
Active immunization. The full course of vaccination with AS-anatoxin (for persons not previously vaccinated against tetanus) consists of two vaccinations with an interval of 30-40 days and a booster at 6-12 months (as an exception, the interval can be extended to 2 years). Subsequent revaccinations are carried out every 10 years by AC- or ADS-M-anatoxin once.
Immunization of some (elderly people, unorganized population), taking into account specific conditions in individual localities, may be carried out by a decision of the Ministry of Health of the Russian Federation according to a reduced scheme providing for a single introduction AC-anatoxin in a double dose (1.0 ml) with the first revaccination in the period from 6 months to 2 years and subsequent revaccinations every 10 years with usual doses of the drug (0.5 ml).
Note. Active immunization of children against tetanus from 3 months is carried out in a planned manner by adsorbed pertussis-diphtheria-tetanus vaccine (DTP-vaccine), or adsorbed diphtheria-tetanus toxoid (ADS- or ADS-M-anatoxin) in accordance with the instructions for the use of drugs.
Emergency prophylaxis of tetanus.
Emergency specific prevention tetanus is carried out at:
-faults with integrity violation skin and mucous membranes;
- frostbite and burns (thermal, chemical, radiation) of the second, third and the fourth degree;
-hospital abortions;
- outside of medical institutions;
gangrene or tissue necrosis of any type, long-term abscesses;
-bites by animals;
penetrating damage gastrointestinal tract.
Emergency tetanus prophylaxis provides for primary surgical treatment of the wound and the creation, if necessary, of specific immunity against tetanus. Emergency Immunoprophylaxis should be carried out as soon as possible from the time of injury, up to 20 days, given the duration of the incubation period for tetanus.
For emergency specific prevention of tetanus use:
-A-toxoid;
-immunoglobulin antitetanus human (IPHS);
- In the absence of IPSH, anti-tetanus horse purified concentrated liquid (PSS) serum.
The choice of prophylactic agents for emergency specific tetanus prophylaxis is presented in Table 1.
The AS-anatoxin is injected deep into the subcutaneous region.
IPSCH is administered at a dose of 250 ME intramuscularly into the upper-outer quadrant of the buttocks.
PSS is administered at a dose of 3000 ME subcutaneously (see the instructions for use of anti-tetanus serum).
Note. Before the introduction of tetanus toxoid to determine the sensitivity to a foreign protein, an intradermal test with horse serum diluted 1: 100 is mandatory (it is available as a complete set with PSS). The introduction of the drug is registered in the established registration forms with the indication of the serial number, expiration date, the enterprise manufacturer, date of introduction.
Table 1
The scheme of the choice of preventive measures in carrying out an emergency specific tetanus prophylaxis
| Previous vaccinations against tetanus A drug containing tetanus toxoid | Age group | Dates after the last vaccination | The drugs used |
| AC1-anatoxin | IPSC2 | MSS |
| 1 | 2 | 3 | 4 | 5 | 6 |
| There is a documentary evidence of vaccination |
| Full course of planned vaccinations according to age | Children and teens | Regardless of the term | Do not inject3 | Do not inject | Do not inject |
| The course of routine vaccinations without the last age-related revaccination | Children and teens | Regardless of the term | 0.5 ml | Do not inject |
| Full immunization schedule4 | Adults | Not more than 5 years | Do not inject |
| More than 5 years | 0.5 ml | Do not inject |
| Two Inoculations5 | All ages | Not more than 5 years | 0.5 ml | Do not inject |
| More than 5 years | 1.0 ml | 250 ME | 3000 ME7 |
| One inoculation | All ages | Not more than 2 years | 0.5 ml | Do not inject6 |
| More than 2 years | 1.0 ml | 250 ME | 3000ME7 |
| Not vaccinated | Children up to 5 months |
| Not introduce9 | 250 ME |
|
| Other ages |
| 0.5 ml7, 8 | 250 ME | 3000 ME |
| There is no documentary evidence of vaccination |
| In the anamnesis there were no contraindications to inoculations | Children up to 5 months |
| Do not inject | 250 ME |
|
| Children from 5 months, teenagers, military personnel |
| 0.5 ml | He introduce6 |
| In the anamnesis there were no contraindications to inoculations | Former servicemen |
| 0.5 ml | He introduce6 |
| Other contingents | All ages |
| 1.0 ml | 250 ME | 3000 ME |
|
|
|
|
|
| | | |
Note. 1. Instead 0,5 ml AC-atoxin can be used ADS-M-anatoxin if vaccination against diphtheria with this drug is necessary. If wound localization allows, the AS-anatoxin is preferably administered to the area of its location by subcutaneous cleavage. 2. Use one of these drugs: IPSC or MSS (it is preferable to introduce IPAH).
3. In case of "infected" wounds, 0.5 ml of AC-anatoxin is administered if after the last booster, 5 years or more have passed.
4. Full immunization schedule AC-anatoxin for adults consists of two inoculations of 0.5 ml each with an interval of 30-40 days and a booster at 6-12 months with the same dose. Under the reduced scheme the full course of immunization includes a single vaccination AC-anatoxin in a doubled dose (1 ml) and revaccination at 6 months - 2 years with a dose of 0.5 ml of AS-toxoid.
5. Two inoculations according to the usual scheme of immunization (for adults and children) or one inoculation under the reduced scheme of immunization for adults.
6. In case of "infected" wounds, IPSH or PSS are administered.
7. All persons who received active-passive prophylaxis should be revaccinated with 0.5 ml of AS-anatoxin to complete the course of immunization after 6 months - 2 years.
8. If necessary, assign AC-Anatoxin for children under 6 years of age the drug should be administered intramuscularly.
9. After the normalization of the post-traumatic state, children should be vaccinated with DTP vaccine.