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Tetanus injection

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read

The tetanus vaccine protects against a potentially life-threatening bacteria called Clostridium tetani, which releases the tetanus toxin. The bacteria is found in the environment worldwide, in soil or manure, and enters the body via any scratches, puncture wounds, burns, or other skin breaks. It's a significant cause of neonatal death in some African countries, but part of the vaccination program offered to all babies in the US.

Symptoms of tetanus toxin infection include muscle spasms and stiffness or rigidity. This stiffness affects the jaw (causing lockjaw) and neck first, before affecting the rest of the body, and usually requires life support.

When should I or my child get the tetanus vaccine?

The tetanus vaccine is offered as part of the usual US vaccination program for babies, and is given combined with other vaccines at 2 months, 4 months, 6 months, 15-18 months, and 4-6 years old. A booster is given at 11-12 years of age. If the schedule is delayed or interrupted for any reason, there is a recommended catch-up schedule. At least one month should be allowed between each of the three vaccines.

For most babies, tetanus is included in a single shot containing vaccines against diphtheria and pertussis (whooping cough).

When should I or my child get a tetanus booster?

A booster is a smaller dose of the original vaccine, and reinforces the immune response established with the first set of vaccines, to give you continued protection against tetanus bacteria.

The first booster dose is routinely offered to those 11-12 years of age, and it should be at least 3 years since your child received their last vaccine.

The second booster dose should be given 10 years after the first booster, and, again, every 10 years thereafter.

Any open wound can put you at risk of tetanus, but those that are likely to be contaminated with debris from the ground or a puncture wound, burn, or fracture with skin break are at higher risk. Road traffic accidents, gardening accidents, or other outdoor injuries and animal bites or scratches are considered high risk.

If vaccination status is unclear, or someone has not completed their tetanus vaccination schedule, they should be offered a tetanus booster urgently. This can be administered by your nurse or by a hospital nurse or doctor if you attend there. You should ensure you get this ASAP after any injury causing an open wound.

Is anyone at greater risk of tetanus?

Those who inject street or party drugs are at increased risk, as they may use needles contaminated with tetanus, and they may have other skin infections or abscesses that encourage the growth of tetanus bacteria.

Those who are immunocompromised at the time of a tetanus vaccine – either through a medical condition or medication – may not mount a sufficient response, so they may need to repeat this once they have recovered or ceased their medication course. They should still proceed with the tetanus vaccine if due at the time they are immunosuppressed.

It's safe for pregnant or breastfeeding women, and a combined injection is offered routinely between weeks 27 and 36 of pregnancy alongside pertussis and diphtheria.

What are the risks of a tetanus vaccine?

There are very few reasons someone cannot receive the tetanus vaccine – it's not a live vaccine, so you can't catch tetanus from it. Previous serious allergic reaction to the tetanus shot or any of its components requires expert advice about giving further injections, but anaphylactic reactions – where there is difficulty in breathing – are extremely rare.

Most injections can feel sore as the needle goes in, and for a few hours or days afterward. You can get pain, swelling, and redness around the injection site, and a small painless nodule that usually disappears with time. As the immune system mounts a response, combined childhood vaccines can cause fever and distress. Acetaminophen and/or ibuprofen can help relieve pain and a high temperature.

Vaccination should be postponed if you or your child has a feverish illness, but not mild illness without a fever, and the risks need to be weighed against the benefits if you are feverish and you incur a contaminated wound.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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