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Tetanus Specific Immunoglobulin (TIG) shortage - March 2019

For tetanus-prone injuries, based on a risk assessment on the nature of the wound and immunisation status of the individual, a reinforcing dose of tetanus containing vaccine and/or of a prophylactic dose of tetanus specific immunoglobulin (TIG), given intra-muscularly is recommended. The use of normal preparations of immunoglobulin (Subgam) has been recommended as an alternative to intramuscular TIG (IM TIG). There is currently a severe shortage of IM TIG and Subgam (and alternative HNIG products) available in the NHS for the management of tetanus prone wounds. As a consequence, PHE has urgently reviewed the existing evidence to prioritise the use of TIG /HNIG for susceptible individuals who have sustained high risk injuries and are at greatest risk. See updated PHE guidelines.