If you are stabbed by a nail or a splinter, or a wound gets dirt in it, have it treated that day and ask whether you need a tetanus shot

Cost

Registration plus wound care costs a few dozen CNY. If the doctor says you need a shot, the vaccine or immune globulin costs a few dozen to a few hundred CNY.

What you get

In the U.S., about 1 in 10 tetanus cases ends in death. Deep wounds and wounds contaminated with dirt carry higher risk. China's 2024 clinical guideline sorts wounds into two tiers. A shallow wound treated within 6 hours, with no dirt, feces or animal saliva on it, is low risk. A wound treated after more than 6 hours, contaminated with those things, or that is a puncture, avulsion, crush, burn or frostbite wound, or has a foreign body left in it, is high risk. If you have had 3 or more doses and the last one was less than 5 years ago, you need nothing. If it was 5 to 10 years ago, a high-risk wound needs 1 booster. If it was 10 years or more, any wound needs 1 booster. If you have not had 3 doses or can't remember, the vaccine series must be completed, and for a high-risk wound you also need passive immunization (a shot that gives antibodies directly, such as immune globulin or antitoxin).

Notes

At the hospital, let the doctor judge; don't decide on your own, and don't skip asking because it feels like a hassle. Not every wound needs a shot. The doctor will look at which tier the wound falls in, ask when you last had a shot, and then decide. “A childhood shot protects you for life” is wrong. If the wound is dirty, you need a booster once 5 years have passed since the last shot. So before you go, think about what year your last tetanus shot was.

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

1. US Centers for Disease Control and Prevention. Tetanus: "Tetanus bacteria can get into someone's body through broken skin, usually through injuries." "Tetanus can lead to death (1 in 10 cases in the United States are fatal)." "People who didn't complete the primary series or who aren't up to date with their 10-year tetanus booster shots are also at increased risk." "Vaccination also helps prevent tetanus in people with wounds, depending on their tetanus vaccination history." https://www.cdc.gov/tetanus/about/index.html
2. General Office of the National Health Commission of China (2024). Notice on Issuing the Guidelines for the Diagnosis and Treatment of Non-Neonatal Tetanus (2024 Edition) [in Chinese] (Guo Wei Ban Yi Ji Han [2024] No. 381; risk grading on page 16 of the annex, Table 4 on page 20). https://www.gov.cn/zhengce/zhengceku/202410/content_6982262.htm
3. Annex PDF (scanned copy). https://www.gov.cn/zhengce/zhengceku/202410/P020241023483425528555.pdf

Translated from the Chinese original. Original book, section 1, tip 15. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer