Do You Need a Tetanus Shot?

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Tetanus, sometimes called lockjaw, is a rare disease caused by bacteria known as Clostridium tetani. A toxin produced by the bacteria affects the function of the nerves and leads to severe muscle spasms in the abdomen, neck, stomach, and extremities. Tetanus can either be localized to one part of the body or generalized, with muscle spasms throughout the body. The disease has been called lockjaw since the muscle spasms in the face and neck can lead to the inability to open the mouth, and this is one of the most common symptoms of tetanus. Tetanus is a serious illness that is fatal in up to 30% of cases.

The bacteria that cause tetanus can be found in soil, manure, or dust. They infect humans by entering the body through cuts or puncture wounds, particularly when the wound area is dirty. Animal bites, burns, and non-sterile injection of drugs can also lead to infection with Clostridium tetani. The first symptoms of tetanus can appear any time from three days to weeks after infection, but the average time until symptom onset is eight days. Tetanus is not contagious, so you cannot acquire the disease from someone who has it.

The tetanus vaccine is a toxoid, meaning that it protects against the toxin produced by the bacteria. Developed in the 1920s, tetanus vaccination became routinely used as a part of childhood immunizations in the U.S. after World War II, and it is considered to be essentially 100% effective in preventing tetanus. Tetanus immunization is almost always administered to children in the form of the DTaP vaccine, which also protects against diphtheria and pertussis. Tetanus toxoid can also be given in combination with diphtheria vaccine alone in both adult (Td) and pediatric (DT) formulations.

Infants are commonly given the DTaP vaccine in a schedule of four doses at 2, 4, 6, and 15-18 months of age. Another dose is administered at 4 to 6 years of age. Because the levels of antitoxin in the body gradually fall over time, booster vaccinations with the combined diphtheria-tetanus toxoid (Td) are recommended every 10 years. Td is a tetanus-diphtheria vaccine given to adolescents and adults as a booster shot every 10 years or after a presumed exposure in some cases, while Tdap is a similar vaccine that also contains protection against pertussis. A single dose of Tdap is recommended for children at the 11- to 12-year-old checkup.

If it has been more than 10 years since your last tetanus booster, contact your doctor to bring your immunizations up to date. A booster vaccination is also recommended if you sustain a deep, contaminated wound and more than five years have passed since the last dose, since protective antibody levels may fall after five years in some people. You should also receive a series of three tetanus immunizations if you did not receive the childhood vaccine.

Serious adverse reactions from the tetanus shot are very rare. Mild reactions include localized swelling, tenderness, and redness at the injection site that generally persist for one to two days after vaccination.

REFERENCE:

United States. Centers for Disease Control and Prevention. "Tetanus (Lockjaw) Vaccination." May 16, 2011. <http://www.cdc.gov/vaccines/vpd-vac/tetanus/default.htm>.


Last Editorial Review: 9/19/2011



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