Tetanus is rare in Australia thanks to a very effective vaccination program, but the consequences of contracting it are severe enough that we don't take chances. The decision about whether you need a booster after a wound is based on two questions — and we ask them every single time.
The two-question rule
- When was your last tetanus booster? If you can't remember, assume more than 10 years.
- What is the wound like? Tetanus-prone wounds are deep, contaminated with soil or saliva, contain foreign material, or are puncture wounds.
The decision tree based on these two answers:
- Last booster less than 5 years ago — no booster needed, regardless of the wound.
- Last booster 5 to 10 years ago, clean minor wound — no booster needed.
- Last booster 5 to 10 years ago, tetanus-prone wound — booster recommended tonight.
- Last booster more than 10 years ago, any wound — booster recommended tonight.
- Never vaccinated, or unsure of history, with any wound — booster recommended tonight, plus possible tetanus immunoglobulin for high-risk wounds (we'd usually refer this scenario to ED).
The Australian schedule explained
Australian children receive tetanus vaccines as part of the routine childhood schedule (6 weeks, 4 months, 6 months, 18 months, 4 years), then a school-age booster around 12–13 years. Adults are recommended to have a booster at age 50, and again at age 65 if it has been more than 10 years since their last dose.
If you were vaccinated as a child in Australia and you're under 50, you're probably well-covered for clean minor wounds. The reason we still ask is that the protective antibody level drops over time, and for a serious wound we want a margin of safety.
Tetanus-prone wounds — what counts
These wounds are tetanus-prone
- Puncture wounds (nails, splinters, animal teeth)
- Wounds contaminated with soil, dust, faeces, or saliva
- Deep wounds where you can't see the bottom
- Burns and frostbite
- Wounds containing foreign material (gravel, glass, organic material)
- Wounds more than 6 hours old
- Crush injuries with significant devitalised tissue
What the injection actually is
The standard adult booster in 2026 is ADT (adult diphtheria/tetanus) or dTpa (adult diphtheria/tetanus/acellular pertussis). dTpa is preferred if you haven't had pertussis cover in the past 10 years. The injection goes in the deltoid muscle, takes about 10 seconds, and the most common side effect is a sore arm for a day or two. Antibody levels rise within 7–10 days, so the booster is still useful even if given a few days after the wound.
What we charge
The tetanus booster itself is included in the cost of your wound consultation — there is no separate vaccine fee. If you came in only for a booster (which is rare), it's a $250 + GST visit.
If you don't know your tetanus history
Don't worry. The safe rule is "if in doubt, give a booster." There is no harm in having an extra dose if you happened to be up to date.