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Tetanus Vaccine by Krisha McCoy, MS

What Is Tetanus?

Tetanus is a bacterial infection that attacks the nervous system. Tetanus may result in severe muscle spasms, and this can lead to a condition known as lockjaw, which prevents the mouth from opening and closing. Tetanus can be fatal.

Tetanus is caused when the bacterium, Clostridium tetani , enters the body through a break in the skin. The bacterium can come from soil, dust, or manure. It produces a toxin that causes the illness.

In the United States and other countries with tetanus vaccination programs, the condition is rare.

What Is the Tetanus Vaccine?

The tetanus vaccine is an inactivated toxoid (a substance that can create an antitoxin). There are different types of the vaccines to prevent tetanus, including:

DTaP—given to children to protect against diphtheria , tetanus, and pertussis
Tdap—given to children, adolescents, and adults (including pregnant women) to protect against tetanus, diphtheria, and pertussis
Td—given to adolescents and adults to protect against tetanus and diphtheria

Who Should Get Vaccinated and When?

DTap

The DTaP vaccine is generally required before starting school. The regular immunization schedule is to give the vaccine at:

2 months
4 months
6 months
15-18 months
4-6 years

Tdap

Tdap is routinely recommended for children aged 11-12 years who have completed the DTaP series. Tdap can also be given to:

Children aged 7-10 years who have not been fully vaccinated
Children and teens aged 13-18 years who did not get the Tdap when they were 11-12 years old
Adults under 65 years who have never received Tdap
Pregnant women after 20 weeks gestation who have not previously received Tdap
Adults who have not been previously vaccinated and who have contact with babies aged 12 months or younger
Healthcare providers who have not previously received Tdap

Td

Td is given as a booster shot every 10 years. The vaccine may also be given if you have a severe cut or burn.

Catch-Up Schedule

If you or your child has not been fully vaccinated against tetanus, talk to the doctor.

What Are the Risks Associated With the Tetanus Vaccine?

Most people tolerate the tetanus-containing vaccines without any trouble. The most common side effects are pain, redness, or swelling at the injection site, mild fever, headache, tiredness, nausea, vomiting, diarrhea , or stomachache.

Rarely, a fever of more than 102ºF, severe gastrointestinal problems, or severe headache may occur. Nervous system problems and severe allergic reactions are extremely rare. Localized allergic reactions (redness and swelling) at the injection site may occur, while anaphylaxis (life-threatening, widespread allergic reaction) is extremely rare.

Acetaminophen (eg, Tylenol) is sometimes given to reduce pain and fever that may occur after getting a vaccine. In infants, the medicine may weaken the vaccine's effectiveness. However, in children at risk for siezures, a fever lowering medicine may be important to take. Discuss the risks and benefits of taking acetaminophen with the doctor.

Who Should Not Get Vaccinated?

The vast majority of people should receive their tetanus-containing vaccinations on schedule. However, individuals in whom the risks of vaccination outweigh the benefits include those who:

Have had a life-threatening allergic reaction to DTP, DTap, DT, Tdap, or Td vaccine
Have had a severe allergy to any component of the vaccine to be given
Have gone into a coma or long seizure within seven days after a dose of DTP or DTaP

Talk with your doctor before getting the vaccine if you have:

Allergy to latex
Epilepsy or other nervous system problem
Severe swelling or severe pain after a previous dose of any component of the vaccination to be given
Guillain-Barre syndrome

Wait until you recover to get the vaccine if you have moderate or severe illness on the day your shot is scheduled.

What Other Ways Can Tetanus Be Prevented Besides Vaccination?

Caring properly for wounds, including promptly cleaning them and seeing a doctor for medical care, can prevent a tetanus infection.

WHERE CAN I GET MORE INFORMATION?
Immunization Initiatives American Academy of Pediatrics http://www.cispimmunize.org/
National Immunization Program Centers for Disease Control and Prevention http://www.cdc.gov/vaccines/

References:

Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2009. Ann Intern Med . 2009;150:40-44.
CDC National Immunization Program website. Available at: http://www.cdc.gov/nip/ . Accessed February 5, 2007.
Immunization Action Coalition website. Available at: http://www.immunize.org/ . Accessed February 5, 2007.
National Foundation for Infectious Diseases website. Available at: http://www.nfid.org/ . Accessed February 5, 2007.
Nemours Foundation website. Available at: http://www.nemours.org/index.html . Accessed February 5, 2007.
Recommended adult immunization schedule—United States, 2010. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/PDF/wk/mm5901-Immunization.pdf . Published January 15, 2010. Accessed January 24, 2011.
Recommended adult immunization schedule—United States, 2012. MMWR Morb Mortal Wkly Rep . 2012;6(4). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/recs/schedules/downloads/adult/mmwr-adult-schedule.pdf . Accessed February 24, 2012.
Recommended immunization schedule for persons aged 0 through 6 years—United States 2010. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2010/10_0-6yrs-schedule-pr.pdf . Accessed January 24, 2011.
Recommended immunization schedule for persons aged 7 through 18 years—United States 2010. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2010/10_7-18yrs-schedule-pr.pdf . Accessed January 24, 2011.
Recommended immunization schedule for persons aged 7 through 18 years—United States 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/recs/schedules/downloads/child/7-18yrs-schedule-pr.pdf . Accessed February 24, 2012.
Tetanus, diphtheria (Td) or tetanus, diphtheria, pertussis (Tdap) vaccine: what you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2010/10_0-6yrs-schedule-pr.pdf . Published November 18, 2008. Accessed January 24, 2011.
1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm . Updated January 10, 2008. Accessed January 28, 2008.
10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Prymula R, Siegrist C, Chlibek R, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet . 2009;374(9698):1339.
1/24/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (tdap) vaccine from the advisory committee on immunization practices, 2010. MMWR Morb Mortal Wkly Rep. 2011;60(1):13-15.
11/4/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months—Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011;60:1424-1426.

Last reviewed June 2012 by Lawrence Frisch, MD, MPH

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