What is tetanus?

Children typically get the DTaP vaccine as part of their routine childhood vaccinations.
Children typically get the DTaP vaccine as part of their routine childhood vaccinations.

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 3 days to weeks after infection, but the average time until symptom onset is 8 days. Tetanus is not contagious, so you cannot acquire the disease from someone who has it.

Tetanus Symptoms and Signs

During a one- to seven-day period, progressive muscle spasms caused by the tetanus toxin in the immediate wound area may progress to involve the entire body in a set of continuous muscle contractions. Restlessness, headache, and irritability are common.

The tetanus neurotoxin causes the muscles to tighten up into a continuous ("tetanic" or "tonic") contraction or spasm. The jaw is "locked" by muscle spasms, giving the name "lockjaw" (also called "trismus"). Muscles throughout the body are affected, including the vital muscles necessary for normal breathing. When the breathing muscles lose their power, breathing becomes difficult or impossible and death can occur without life-support measures (mechanical ventilation). Even with breathing support, infections of the airways within the lungs can lead to death.

When should you get a tetanus shot? How long does it last?

DTap and Tdap vaccination schedule is:

  • Infants are commonly given the DTaP (diphtheria, tetanus, and pertussis) 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.
  • 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 5 years have passed since the last dose, since protective antibody levels may fall after 5 years in some people. You should also receive a series of three tetanus immunizations if you did not receive the childhood vaccine.

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 (whooping cough).

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What are abbreviations for the tetanus shot?

  • Tetanus immunization is almost always administered to children in the form of the DTaP vaccine, which also protects against diphtheria and pertussis (whooping cough).
  • Tetanus toxoid can also be given in combination with diphtheria vaccine alone in both adult (Td) and pediatric (DT) formulations.

What are possible reactions and side effects of a tetanus shot?

  • 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 1-2 days after vaccination.

What is the effectiveness of the tetanus shot?

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.

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Medically Reviewed on 10/17/2019
References
United States. Centers for Disease Control and Prevention. "Tetanus Vaccination." Feb. 28, 2019. <http://www.cdc.gov/vaccines/vpd-vac/tetanus/default.htm>.
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