Quick answer
The CDC recommends getting a tetanus booster shot every 10 years. Adults should get a Td booster shot once every 10 years. After an injury that may cause tetanus infection, you may need a TIG shot along with a Td booster depending on when you last received a tetanus vaccine. Keeping up to date with your 10 year tetanus booster shots is the best way to prevent tetanus.
What is tetanus?
Tetanus, also known as lockjaw, is a serious bacterial infection caused by Clostridium tetani. The bacteria produce a toxin that affects the brain and nervous system, leading to stiffness in the muscles.
The tetanus bacteria are present in soil, dust, and manure. The bacteria can enter the body through broken skin, usually through injuries like puncture wounds, burns, crush injuries, scratches, and cuts.
When the tetanus bacteria invade the body, they produce the tetanus toxin. This poisonous toxin causes painful muscle contractions, particularly in the jaw (lockjaw) and neck. It can also affect other muscles throughout the body.
Tetanus is a medical emergency that requires hospitalization. It can lead to serious health complications like breathing difficulty, high blood pressure and heart rate, and death in up to 10-20% of cases.
Tetanus vaccine
Tetanus can be prevented through vaccination. Doctors recommend a series of tetanus shots for all children and adults.
There are two types of tetanus shots given:
– DTaP vaccine: This is the diphtheria, tetanus, and pertussis (whooping cough) vaccine given to children as a series of five doses at 2, 4, 6, and 15-18 months, and 4-6 years old.
– Tdap or Td vaccine: This is the tetanus, diphtheria, and pertussis booster shot given to preteens at 11-12 years old, or as a tetanus diphtheria (Td) booster for adults.
The tetanus vaccine is about 95% effective in preventing tetanus. Immunity from both natural infection and immunization is not permanent or lifelong. This requires getting booster shots throughout life to maintain immunity against tetanus.
How often should you get a tetanus booster?
Childhood DTP or DTaP vaccine schedule
The CDC’s recommended childhood vaccination schedule for tetanus is:
– 2 months: First dose of DTaP
– 4 months: Second dose of DTaP
– 6 months: Third dose of DTaP
– 15-18 months: Fourth dose of DTaP
– 4-6 years: Fifth dose of DTaP
This five dose DTaP series is needed to build up high immunity to tetanus in childhood. Most children get the first three doses by 6 months of age. The fourth dose is given just before entering preschool, and the fifth dose when starting elementary school.
Preteen/adolescent Tdap vaccine
The CDC recommends one dose of the Tdap vaccine at age 11-12 years old. This is recommended as a routine booster to maintain ongoing immunity against tetanus alongside diphtheria and pertussis.
Adult Td booster vaccine schedule
All adults need to continue getting Td booster shots every 10 years. This is recommended for optimal protection against tetanus throughout adulthood.
The CDC adult Td booster recommendations are:
– Get a dose of Tdap vaccine first instead of Td if you have never received it before as an adolescent or adult.
– After getting the Tdap vaccine, get a Td booster shot every 10 years.
Adults should consult with a doctor and ensure they get a tetanus booster at least every 10 years. Keeping up with regular 10 yearly Td boosters is necessary to protect against waning immunity as you age.
After a tetanus-prone wound or injury
If you have a wound or injury that puts you at risk of tetanus infection, you may need an additional tetanus vaccine. Clean cuts or minor wounds typically do not warrant extra tetanus shots.
However, you should consult a doctor about next steps if the injury is:
– Contaminated with dirt, feces, soil or saliva
– A puncture wound
– A burn
– An open fracture
The doctor will check when your last tetanus booster was to determine if you need:
– Td booster shot: If your last vaccine was more than 5 years ago
– Tdap or Td booster: If your last vaccine was 5-10 years ago
– TIG (tetanus immune globulin) shot: If your last vaccine was more than 10 years ago or uncertain. TIG provides short term immunity alongside a Td booster.
Why tetanus boosters are needed throughout life
Immunity from both tetanus infection or immunization weakens over time. Tetanus booster shots throughout life help provide an immunity “boost” and prolong protection.
Immunity diminishes faster in older adults due to immunosenescence, or age-related decline in immune function. Childhood tetanus vaccines also do not necessarily provide lifetime immunity.
Key reasons lifelong tetanus boosters are recommended:
Tetanus immunity decreases over time
Immunity from childhood tetanus vaccinations can start decreasing within 5-10 years. Immunity can wane significantly after 10 years without a booster.
Studies have found almost 50% of people do not have protective tetanus antibody levels after 10 years from their last dose. The vaccine effectiveness declines about 80% every 20 years.
Tetanus prone wounds can occur at any age
While tetanus infection is rare in the general population due to vaccination, it poses a higher risk in the unvaccinated. Tetanus prone wounds and injuries can occur at any age, whether due to gardening, construction work, farming, piercings, tattoos, falls, burns, animal bites, surgery, dental infections, injecting drug use, and more.
Adults lose immunity faster than children
Immunity from tetanus vaccination diminishes more rapidly among older adults compared to school-age children due to immunosenescence. Many adults may remain unprotected despite childhood vaccinations.
One study found nearly 70% of older adults did not have adequate tetanus immunity levels. Regular adult Td boosters help overcome waning immunity with age.
Herd immunity requires maintenance
Continual tetanus vaccination helps maintain herd or community immunity. High vaccination rates in the population are needed to prevent person-to-person spread of infectious diseases. Lifelong tetanus boosters help sustain immunity levels and protection.
Vaccines strengthen immune memory
Booster shots reinforce the immune system’s “memory” against tetanus. After initial tetanus vaccines, subsequent vaccine doses help stimulate the immune system to produce more targeted and longer lasting antibodies and defense cells.
Possible side effects of the tetanus shot
The DTaP and Tdap vaccines are very safe and effective with minimal risks involved. Most people do not have any problems after getting their tetanus shots.
The tetanus vaccine can sometimes cause:
Common side effects
– Soreness, redness or swelling at injection site
– Fever
– Headache
– Fatigue
– Nausea or vomiting
– Stomach pain
– Joint pain
– Body aches
– Rash
These vaccine reactions are usually mild and resolve within 1-2 days. Using a cool compress at the injection site can provide relief. Over-the-counter pain relievers like acetaminophen can also help reduce fever and discomfort.
Rare side effects
In very rare cases, the DTaP or Tdap vaccine can trigger:
– Severe allergic reaction (anaphylaxis)
– Long term seizure, coma or brain damage
– Life-threatening complication of nervous system disorder
– Severe pain and swelling of shoulder
Allergic reactions occur within minutes to hours of getting vaccinated. Talk to your doctor if you have any severe adverse effects after a tetanus vaccine. Report any concerning symptoms or health issues to the CDC’s Vaccine Adverse Event Reporting System (VAERS).
Who should avoid or delay tetanus shots?
These individuals may be advised not to get the tetanus vaccine:
– Severe allergic reaction after a previous dose
– People with a neurologic condition
– Pregnant women
– Those with weakened immune system
Talk to your doctor first before getting the tetanus vaccine if you have any concerns about pre-existing conditions or risks factors. Your doctor can help determine if it is safe for you to be vaccinated against tetanus.
Can you get tetanus if you are vaccinated?
Yes, it is still possible but extremely rare to get tetanus even if you have been vaccinated. However, completed vaccination schedules and tetanus booster shots provide very good protection against tetanus.
No vaccine is 100% effective. About 5% of fully vaccinated people may still remain susceptible to tetanus. But the benefits far outweigh the risks, as vaccination has led to an estimated 95% decline in tetanus cases and mortality over the past 50 years.
Vaccinated people who get tetanus are likely to develop milder disease compared to the unvaccinated. Tetanus cases among vaccinated individuals are less severe, less fatal, and more responsive to treatment.
However, gaps in getting recommended tetanus boosters can increase risk for tetanus. Adults who do not keep up with routine 10 yearly Td boosters have a higher risk of waning immunity against tetanus.
Can you get tetanus after a puncture wound if vaccinated?
Yes, there is still a small risk of getting tetanus after a puncture wound even if you are vaccinated. However, your overall chances are lower if your tetanus vaccinations are up to date.
Puncture wounds, like from a nail or needle, allow tetanus bacteria to get deep into the skin where oxygen is limited. This anaerobic environment encourages tetanus bacteria to multiply and produce more toxin. Prompt wound care and tetanus prevention steps can lower infection risk.
Consult your healthcare provider after a puncture injury to review:
– Tetanus immunization status: Need for a Td booster or TIG depends on when you last got a tetanus shot
– Wound assessment: May require antibiotics, tetanus antitoxin or booster vaccine
– Wound cleaning: Remove foreign objects, clean out dirt and debris
– Medical care: May involve stitches, medications or lab tests
Keeping up with the CDC recommended tetanus shot schedule provides the best protection after any wound, including from punctures. But certain tetanus-prone wounds may still warrant an extra Td booster or TIG for added protection.
Conclusion
Tetanus boosters are recommended throughout life to prevent waning immunity to this dangerous infection. Make sure to get the 5-dose childhood DTaP series, a Tdap booster at 11-12 years old, and Td boosters every 10 years as an adult.
Consult your doctor if you have a tetanus-prone wound or are unsure of your vaccination status. Keeping your tetanus shots up to date is safe and provides optimal protection against lockjaw. Tetanus boosters reinforce immunity to ensure you stay protected through all stages of life.
