Tetanus prophylaxis in horses: guidelines for New Zealand and Australia based on a critical appraisal of the evidence.
Abstract: Horses are exquisitely sensitive to tetanus neurotoxin and are exposed to the risk of infection with throughout life. The vaccine against tetanus is highly effective at preventing disease, whereas tetanus in unvaccinated populations is associated with high mortality rates. Current guidelines in New Zealand and Australia for the available vaccine contain contradictions and limitations surrounding the optimal tetanus immunisation protocols for both adult horses and foals. This review critically evaluates the scientific literature on tetanus prophylaxis in horses within the context of equine practice and available products in New Zealand and Australia. The review was conducted by a panel of industry and specialist veterinarians to obtain agreement on nine equine tetanus prophylaxis guidelines for practising veterinarians. The primary protocol for tetanus toxoid (TT) immunisation consists of a three-dose series IM for all horses ≥ 6 months of age, and a four-dose series IM is proposed if commencing vaccination in foals between 3 and 6 months of age. Tetanus prophylaxis in foals < 3 months of age relies on passive immunity strategies. Following the completion of the primary protocol, a TT booster dose IM should be administered within 5 years, and every 5 years thereafter. When followed, these protocols should provide adequate protection against tetanus in horses. Additional tetanus prophylaxis guidelines are provided for veterinarians attending a horse experiencing a known "risk event" (e.g. wound, hoof abscess, surgery, umbilical infection). When a correctly vaccinated horse experiences a risk event, pre-existing immunity provides protection against tetanus. When an unvaccinated horse or one with unknown vaccination status, or a foal born to an unvaccinated dam, experiences a risk event, TT IM and tetanus antitoxin (TAT) 1,500 IU SC should be administered simultaneously at separate sites, and the TT primary immunisation protocol should subsequently be completed for the horse's respective age. In previously immunised pregnant broodmares, a TT booster dose administered 4-8 weeks prior to parturition optimises the transfer of passive immunity against tetanus to the newborn foal via colostrum; provided that post-natal IgG concentration in serum is > 800 mg/dL (8 g/L), such foals should be passively protected against tetanus up to 6 months of age. Survivors of clinical tetanus must still receive the primary protocol for vaccination against tetanus. In summary, all horses in New Zealand and Australia should be vaccinated against tetanus with protection maintained throughout life via TT booster doses, facilitated by accurate medical record keeping and client education.
Publication Date: 2024-06-23 PubMed ID: 38910032DOI: 10.1080/00480169.2024.2365283Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Review
Summary
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Overview
- This research article reviews and establishes evidence-based guidelines for tetanus vaccination and prophylaxis in horses specifically in New Zealand and Australia to optimize prevention of tetanus infection and standardize veterinary practices.
Background and Importance
- Horses are highly susceptible to tetanus infections caused by the tetanus neurotoxin.
- Unvaccinated horses have a very high mortality rate if infected with tetanus.
- Vaccination with tetanus toxoid (TT) is highly effective at preventing disease.
- Current existing guidelines in NZ and Australia contained contradictions and lacked clarity regarding optimal vaccination protocols for both adult horses and foals.
Methodology
- A panel of industry and specialist veterinarians critically reviewed existing scientific literature on tetanus vaccination in horses.
- They considered practical equine veterinary practice realities and vaccine availability in New Zealand and Australia.
- Consensus was achieved on nine clear tetanus prophylaxis guidelines tailored to local conditions and practices.
Key Tetanus Prophylaxis Guidelines
- Primary Vaccination Protocols:
- Adult horses aged 6 months or older receive a three-dose intramuscular (IM) series of the tetanus toxoid vaccine.
- Foals starting vaccination between 3 to 6 months of age receive a four-dose IM vaccine series.
- Foals less than 3 months old rely on passive immunity received from the mother, not vaccination.
- Booster Vaccination:
- After completion of the primary series, a booster dose is recommended within 5 years.
- Subsequent boosters should be given every 5 years to maintain immunity lifelong.
- Managing Risk Events: (e.g. wounds, hoof abscesses, surgery, infections)
- For horses with a known risk exposure and confirmed vaccination, existing immunity usually provides protection.
- For unvaccinated horses, those with unknown vaccination status, or foals born to unvaccinated mares, simultaneous administration of TT (IM) and tetanus antitoxin (TAT) subcutaneously (1500 IU) at separate sites is recommended immediately.
- These horses then complete the primary vaccination series according to age.
- Pregnant Broodmares:
- A booster dose 4-8 weeks before foaling enhances transfer of passive immunity to the foal via colostrum.
- Foals with adequate serum IgG (> 800 mg/dL or 8 g/L) at birth are passively protected until about 6 months old.
- Treatment after Clinical Tetanus:
- Horses that survive natural tetanus infection still need to complete the primary vaccination protocol to ensure future protection.
Implications and Recommendations
- Vaccination protocols standardized for NZ and Australia support lifelong tetanus protection in horses.
- Emphasizes accurate medical record keeping and veterinary client education to maintain compliance with vaccination schedules and risk management.
- Delivers clear practical guidance to veterinarians for both routine and risk-based tetanus immunizations.
- Helps reduce tetanus cases and mortality in regional horse populations by closing gaps and clarifying previous inconsistencies in guidelines.
Cite This Article
APA
Lovett AL, Riley CB, Chapman V, Bell B, Bishop B, Grierson A, Johnstone LJ, Sykes BW.
(2024).
Tetanus prophylaxis in horses: guidelines for New Zealand and Australia based on a critical appraisal of the evidence.
N Z Vet J, 72(5), 241-255.
https://doi.org/10.1080/00480169.2024.2365283 Publication
Researcher Affiliations
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand.
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
- Zoetis New Zealand Ltd., Auckland, New Zealand.
- VetSouth Equine, Invercargill, New Zealand.
- Canterbury Equine Surgical Consultancy Ltd., Prebbleton, New Zealand.
- Auckland Veterinary Centre, Takanini, New Zealand.
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand.
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand.
MeSH Terms
- Horses
- Animals
- Tetanus / prevention & control
- Tetanus / veterinary
- Horse Diseases / prevention & control
- New Zealand
- Tetanus Toxoid / administration & dosage
- Australia
- Vaccination / veterinary
- Practice Guidelines as Topic
Citations
This article has been cited 1 times.- Cheng D, Wenying D, Jizheng H, Wei S, Liang L, Guolei H, Hao Y. Systemic immune inflammation index as a predictor of disease severity in tetanus patients: A retrospective observational study.. PLoS One 2024;19(12):e0316196.
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