The statement that life long protection was "probably" given by 5
immunisations was contained in the last edition of the Green Immunisation
Handbook. But there wasn't a consensus on the committee therefore the Table
(much quoted) kept to traditional advice.
Regards
Ray McGlone
----- Original Message -----
From: "Adrian Fogarty" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, May 14, 2002 1:32 AM
Subject: Re: Replacement of tetanus booster for adults
> I couldn't agree more Nick (and Chris Kirke), this is a public health
issue
> and we should steer clear of it. Yes, we do provide active tetanus
> immunisation (albeit only after initial childhood immunisation) but this
is
> largely for historical reasons and is clearly opportunistic. Besides
active
> "booster" immunisation probably does confer some benefit against the
> material accident, unlike initial immunisation. To introduce diphtheria
> vaccination however would require specific patient counselling and consent
> for a non-emergency situation - that's clearly not our job!
>
> All this may become irrelevant however. I heard a rumour last year that
> patients only need five tetanus vaccinations to confer lifelong immunity;
in
> other words, most people will be fully immune by age 15, and should
> therefore never require booster immunisation. However I never heard nor
> could find confirmation from DoH, from PHLS or from BAEM about this. Can
> anyone out there enlighten me?
>
> Adrian Fogarty
>
> ----- Original Message -----
> From: Nick Jenkins
> Subject: Re: Replacement of tetanus booster for adults
>
>
> > It begs the question "should we be providing active immunisation in
A&E?".
> > Clearly we need to passively immunise with the immunoglobulin if the
> patient
> > isn't immunised and has a tetanus prone wound - we just take the
> opportunity
> > of actively immunising with toxoid if they need it. Strictly speaking
> > that's a primary care duty - until now I've been happy to provide it to
> > avoid inconveniencing the patient who, after all, doesn't understand our
> > lines of responsibilty and would feel messed about if I sent them to
their
> > GP to update their tetanus - probably wouldn't go anyway. This will
make
> me
> > reconsider - my job's nothing to do with immunisation against
diptheria -
> > where does it stop? - do we end up entering into the MMR debate??
> > Nick Jenkins
> > A&E Consultant, Abergavenny
>
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