Do You Really Need a Tetanus Shot? (2024)

The tetanus vaccine is used to prevent tetanus. It is given as a combination shot along with the diphtheria and pertussis (whooping cough) vaccines. The tetanus vaccine is delivered in one of four forms:

• DTaP, given to children 2 months to 6 years to prevent diphtheria, tetanus, and pertussis
• Tdap, given to children age 7 and older and to adults to prevent all three diseases
• Td, a booster shot used to boost immunity against tetanus and diphtheria in people age 7 and older

Diseases Treated

The Td, DT, DTaP, and Tdap vaccines have different indications for use and treat specific infectious bacterial diseases.

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% of those infected, but the rate of death is highest among the elderly.

Diphtheria is a bacterial infection that causes a thick covering on the back of the throat. It can lead to breathing problems, heart failure, paralysis, and death. Vaccination of diphtheria has all but eliminated the disease in the United States.

Pertussis is a bacterial infection also known as whooping cough. It can cause severe coughing spells and vomiting as well as difficulty speaking and breathing. Up to 5% of adolescents and adults who have pertussis either experience severe complications or are hospitalized.

Recommendations

Vaccine recommendations in the United States are issued by a panel of experts within the Centers for Disease Control and Prevention (CDC) called the Advisory Committee on Immunization Practices (ACIP).

DTaP Vaccination

The DTaP vaccine is delivered by intramuscular injection in a 0.5-milliliter (mL) dose and given five times between the ages of 2 months and 4 to 6 years. ACIP recommends the following immunization schedule:

• 2 months
• 4 months
• 6 months
• 15 to 18 months
• 4 to 6 years

Tdap and Td Vaccinations

Once they reach 7 years, children should receive the Tdap vaccine instead of DTaP.

Delivered by injection in a 0.5-mL dose, the Tdap vaccine is used routinely as a booster in children ages 11 to 12. It can also be used as a catch-up vaccination in kids who never got their primary series of shots.

It is given in a single dose in adults with no history of receiving Tdap.

In addition, all adults will need a booster shot every 10 years. This booster may be given as either Tdap or Td vaccine, as long as they have received Tdap in the past. If not, the first dose they receive should be Tdap, followed by Tdap or Td for the following/subsequent doses.

One Tdap dose is also recommended during each pregnancy (preferably in the early part of gestational weeks 27 to 36), regardless of when someone was last vaccinated against tetanus.

If you have an injury or wound, you may need a Td or Tdap vaccine administered by intramuscular injection in a 0.5-mL dose, depending on when you last had a tetanus-toxiod-containing vaccine. For clean and minor wounds, it would be given if it had been more than 10 years. For all other wounds, it would be given if it had been more than five years.

DT Vaccination

The DT vaccine is no longer available in the U.S. after it was discontinued by its manufacturer in late 2022. Like the Td vaccine, DT does not protect against whooping cough. DT was only used in children under 7 who should not get pertussis vaccines, such as those who had a severe allergic reaction to a dose of DTaP.

If a child under age 7 has had a reaction to a pertussis-containing vaccine, they may be given the Td vaccine for all of the remaining recommended doses of DTaP, on the same schedule. However, because Td has a lower dose of diphtheria toxoid compared to DT, it may provide sub-optimal protection against diphtheria. The child would also have sub-optimal protection against whooping cough.

Side Effects

The majority of people who receive a tetanus vaccine experience mild side effects that resolve within a day or two. Many will have no side effects at all.

Common side effects of all formulations include:

• Injection site soreness, redness, or swelling
• Muscle aches
• Mild fever
• Headache
• Fatigue

In rare cases, the vaccine may cause a potentially life-threatening whole-body allergy known as anaphylaxis.

Precautions and Contraindications

There are certain people in whom the Td, Tdap, or DTaP vaccine should be avoided, namely anyone who has had a previous anaphylactic reaction to the vaccine or any of its components.

Moreover, it is important to speak with your healthcare provider about the benefits and risks of vaccination 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 (particularly if during your first trimester).

You should not be given DTaP or Tdap if you had encephalopathy (coma, decreased consciousness, prolonged seizures) without an identifiable cause within seven days of administration of a dose of DTP, DTaP, or Tdap.

Summary

Vaccines to prevent tetanus are included in routine childhood vaccines and in booster shots given to adolescents and adults. The DTaP series is given to children to protect against tetanus, diphtheria, and pertussis (whooping cough). A booster of Tdap is given at age 11 to 12 and during each pregnancy.

Adults should receive a booster of Tdap or Td every 10 years. If they have a wound or injury, a booster of Tdap or Td may be given depending on the last dose of a tetanus-toxoid-containing vaccine and the cleanliness or severity of the wound.