Tetanus results from the action of a powerful exotoxin produced by Clostridium tetani. It can be prevented only by active and passive immunization procedures. The vaccine is one of the safest and most effective vaccines ever developed, and is capable of inducing long term protection in individual vaccinees. Adequate immunization before, or during pregnancy can eliminate the risk of neonatal tetanus in infants born in developing countries. In non-immune patients, tetanus prophylaxis requires the use of tetanus immunoglobulin, or tetanus antiserum in addition to adequate wound care.