All About Tetanus Shots

Who Needs Them (and Who Doesn't)

Getty Images/IAN HOOTON

These days you may need just a tetanus shot, or a vaccination against tetanus, diptheria and pertussis. Tetanus is a bacterial infection of the nervous system, also known as lockjaw. Symptoms include muscle stiffness, difficulty swallowing, muscle spasms and seizures. Death occurs in approximately 10 to 20 percent of those infected, but the rate of death is higher among the elderly.

Diphtheria is an infection that causes a thick covering on the back of the throat.

It can lead to breathing problems, heart failure, paralysis and death. Pertussis is an infection also known as whooping cough. It can cause severe coughing spells, vomiting and difficulty speaking and breathing. Up to 5 percent of adolescents and adults who have pertussis either experience complications or are hospitalized as a result of the illness.

Who Needs the Tetanus (Td) Vaccine?

  • All adults who have not been previously been immunized with at least three doses of tetanus and diphtheria vaccine.
  • Anyone who has an injury or wound that could possibly cause tetanus who has not had a vaccine in the past 5 years.
  • All adults should have a Td booster every 10 years.

The Other Option: The Tdap Vaccine

The Tdap vaccine, also referred to as the DPT vaccine, is a vaccine that contains tetanus, diphtheria and pertussis. The DTaP vaccine, which protects against the same illnesses, is administered to infants and children.

The Tdap vaccine is now recommended for certain adults.

Who needs the Tdap vaccine?

  • All adults under age 65 who have never received a Tdap vaccine.
  • Health care workers who work in direct patient care and have not received a Tdap vaccine.
  • Adults in contact with infants under 12 months of age (i.e. health care workers, childcare providers, parents, grandparents under age 65) who have not had a Tdap vaccine. For this group of people, the Tdap may be administered as few as 2 years after a previous Td booster.

    Vaccination Scheduling

    Adults who have been vaccinated against tetanus in the past should receive a Td booster every 10 years. It is now recommended that one of those boosters be replaced with a Tdap to provide protection against pertussis. If you have never had a tetanus vaccine, you will need three doses of Td. For adults between the ages of 18 and 64, one of those three doses may be substituted with Tdap.

    Children are vaccinated against tetanus, diphtheria and pertussis starting at 2 months. The DTaP vaccine is used only in children, and they are given a total of five doses between the ages of 2 months and 5 years.

    Should Anyone Not Be Vaccinated?

    Anyone who has had a previous anaphylactic reaction to this vaccine or anything in it should not get a tetanus shot, nor should anyone with a history of encephalopathy within 7 days of receiving a DTP or DTaP vaccine.

    Discuss the benefits and risks with your doctor if:

    • You have an unstable neurological condition.
    • You have a moderate or severe illness at the time of vaccination.
    • You have ever had Guillain-Barre Syndrome after receiving any vaccine.
    • You have ever had a severe reaction to a vaccine before.
    • You are pregnant. These vaccines are considered safe in the second and third trimesters of pregnancy.

    Tetanus Side Effects

    As is the case with many medications and vaccinations, there are some side effects that are known to occur with a tetanus shot. These side effects include:

    • Soreness, redness or swelling at the injection site
    • Pain
    • Fever
    • Headache
    • Tiredness
    • Nausea, vomiting, diarrhea and stomach ache
    • Serious allergic reaction (rare, but serious)
    • Deep, aching pain and muscle wasting at the injection site 2 to 4 days after vaccine administration (rare, but serious)

    If you have a serious reaction to a vaccine, contact your health care provider or see a doctor immediately.


    “Summary of Recommendations for Adult Immunization” Centers for Disease Control and Prevention 01 April 08.

    “Tetanus Disease In-Short (Lockjaw)”Vaccines and Preventable Diseases 04 June 07. Centers for Disease Control and Prevention. 02 April 08.

    Continue Reading