EDITOR, - J C M Sharp's advice on tetanus immunisation1 is contrary to that specified in the current edition of the “green book.”

For immunised adults who have received five doses of tetanus vaccine, either as children or according to the recommended schedule of immunisation for those aged 10 years and over, booster doses are not recommended, other than at time of injury, since they have been shown to be unnecessary and can cause considerable local reactions.2 Sharp's recommendation that people should have booster doses at 10 year intervals and that boosters should be considered at five year intervals for athletes is now out of date.