If you get pricked by a nail or splinter, or if a wound gets dirty with soil, seek treatment the same day and ask whether a tetanus shot is needed.

15. If you get pricked by a nail or splinter, or if a wound gets dirty with soil, seek treatment the same day and ask whether a tetanus shot is needed.

Cost: Seeing a doctor and having the wound treated typically costs a few dozen yuan. If a shot is recommended, the vaccine or immunoglobulin will add another few dozen to several hundred yuan.

In plain terms: Once tetanus sets in, about 1 out of every 10 people dies. The risk is highest for deep wounds or wounds contaminated with dirt. If a wound is dirty and it’s been 5 years or more since your last tetanus shot, you’ll need a booster. Getting treated the same day costs only a few dozen yuan — don’t wait until the wound starts swelling.

Benefit: In the U.S., roughly 1 out of every 10 tetanus cases ends in death. Deep wounds and those exposed to dirt carry an even higher risk. China’s 2024 treatment guidelines classify wounds into two categories. Wounds treated within 6 hours that aren’t dirty and haven’t been exposed to feces, animal saliva, or soil are considered low‑risk. Wounds treated later, or those contaminated with such substances, as well as puncture wounds, avulsions, crush injuries, burns, frostbite, or wounds containing foreign bodies, are deemed high‑risk. If you’ve received three or more tetanus shots and the most recent one was less than 5 years ago, no further dose is needed. For high‑risk wounds, a booster is required if it’s been 5–10 years since your last shot; after 10 years, a booster is mandatory regardless of risk level. If you’ve never completed the three‑dose series or can’t recall when you last got a shot, you’ll need to finish the series and, for high‑risk wounds, also receive passive immunization (an injection of immunoglobulin or antitoxin that delivers antibodies directly).

Evidence grade: B

Sources: U.S. Centers for Disease Control and Prevention (CDC). 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>; National Health Commission of China (NHC) (2024). (2024 ) (〔2024〕381 , 16 , 4 20 ). <https://www.gov.cn/zhengce/zhengceku/202410/content_6982262.htm>; PDF (). <https://www.gov.cn/zhengce/zhengceku/202410/P020241023483425528555.pdf>

Notes: At the hospital, let the doctor make the decision — don’t guess on your own, and don’t hesitate to ask questions. Not every wound requires a tetanus shot; the doctor will assess the wound category and your vaccination history before deciding. The idea that “one shot in childhood provides lifelong protection” is a myth. If a wound is dirty, a booster is needed after 5 years, so try to recall when you last received a tetanus shot before heading to the clinic.