AC-anatoxin is injected deeply subcutaneously into the subscapular region at a dose of 0.5 ml (single dose). Before vaccination, the ampoule must be shaken thoroughly until a homogeneous suspension is obtained.
The introduction of the drug is registered in the prescribed accounting forms with the indication of the serial number, expiration date, the manufacturer's enterprise, the date of introduction.
Active immunization:
Full course of vaccination AC-anatoxin (for persons not previously vaccinated against tetanus) consists of two inoculations of 0.5 ml with an interval of 30-40 days. And a booster vaccine at 6-12 months once in the same dose (as an exception the interval can be extended to 2 years). Subsequent revaccinations every 10 years AC or ADS-M toxoid once in the same dose.
Immunization some hard-to-reach contingents (elderly people, unorganized population), taking into account the specific conditions in in accordance with the decision of the Ministry of Health and Social Development of the Russian Federation, can be carried out 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 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 use of the drugs.
Emergency prevention of tetanus:
Emergency specific tetanus prophylaxis is performed with:
- trauma with violation of the integrity of the skin and mucous membranes;
- frostbite and burns (thermal, chemical, radiation) second, third and fourth degree;
- community-acquired abortions;
- Delivery outside medical institutions;
- gangrene or necrosis of any type of tissue, long-term abscesses;
- bites by animals;
- penetrating lesions of the gastrointestinal tract.
Emergency tetanus prophylaxis provides for primary surgical treatment of the wound and the creation, if necessary, of specific immunity against tetanus. Emergency tetanus immunization should be given as soon as possible from the time of injury, up to 20 days, given the duration of the incubation period for tetanus disease.
For emergency specific prevention of tetanus use:
- AC-toxoid;
- antitetanus, human immunoglobulin (PCMI);
- in the absence of ANTI serum anti-tetanus horse purified concentrated liquid (PSS).
The choice of prophylactic agents for emergency specific tetanus prophylaxis is presented in Table 1.
PSCHI is administered at a dose of 250 ME intramuscularly into the upper-outer quadrant of the buttock (see the instructions for the use of tetanus antitumor immunoglobulin).
PSS is administered at a dose of 3000 ME under the skin (see the instructions for the use of anti-tetanus serum).
Note: before administration of antitetanus serums to determine the sensitivity to a foreign protein is required to place an intradermal test with horse serum diluted 1: 100 (available in complete with PSS).
Table 1 Scheme of the choice of preventive measures in the conduct emergency specific tetanus prophylaxis.
| Prior vaccinations against tetanus | Age Group | Timing, after the last inoculation | The drugs used |
| Presence of documents on previous vaccinations | Previous vaccinations against tetanus by any drug, containing tetanus toxoid | AC1 | PCMI1 | MSS |
| There is a documentary immunization confirmation | Full course of planned vaccinations according to age | Children and teens | Regardless of the term | Not Introduce3 | Not introduce | He introduce |
| Course of planned inoculations without the last age-related revaccination | Children and teens | Regardless of the term | 0.5 ml | Not introduce | He introduce |
| Full immunization schedule4 | Adults | Not more than 5 years More than 5 years | Do not inject, 0.5 ml | Do not inject Do not inject | Do not inject Do not inject |
| Two Inoculations5 | All ages | Not more than 5 years More than 5 years | 0.5 ml 1.0 ml | Not 250 ME | He introduce 3000 ME7 |
| One inoculation | All ages | Not more than 2 years More than 2 years | 0.5 ml 1.0 ml | Do not inject6 250 ME | Do not inject6 3000 ME7 |
| Not vaccinated | Children up to 5 months. The rest of the age | -
| Do not inject8 0.5 ml 7 | 250 ME 250 ME | 3000 ME 3000 ME |
| No documented confirmation of vaccination | In the anamnesis was not contraindications to vaccinations | Children up to 5 months. | -
| Not introduce | 250 ME | 3000 ME |
| Children from 5 months., adolescents | - | 0.5 ml | He introduce6 | He Introduce6 |
| military personnel, ex-servicemen | -
| 0.5 ml | He Introduce6 | He Introduce6 |
| Other contingents | All ages | -
| 1.0 ml | 250 ME | 3000 ME |
Notes:
1. Instead of 0.5 ml of AS, you can use ADS-M if vaccination against diphtheria is necessary.
2. Use one of these drugs: PSIH or PSS (it is preferable to introduce PCHI).
- In case of "infected" wounds, 0.5 ml of AS are injected, if after the last revaccination has passed 5 or more years.
- The full course of immunization of AS for adults consists of two inoculations of 0.5 ml each with an interval of 30-40 days and a revaccination through 6-12 months in the same dose. According to the reduced scheme, the full course of immunization includes a single vaccination of the AC in a doubled dose (1.0 ml) and a booster dose after 1-2 years in a dose of 0.5 ml AS.
- Two vaccinations according to the usual immunization schedule (for adults and children) or one inoculation with a reduced immunization schedule for adults.
- In the case of "infected" wounds, POCs or PSS are administered.
- All persons who received active-passive prophylaxis should be revaccinated with 0.5 ml of AS to complete the course of immunization after 6 months - 2 years.
- After normalizing the post-traumatic state, children should be vaccinated with DTP vaccine.