What you need to know
- Tetanus is a serious bacterial infection that attacks the nerves that control muscles, causing painful spasms that can be fatal if untreated.
- The bacteria typically enter the bloodstream through breaks in the skin, such as cuts, bites, burns, and unsanitary injections. Anyone who’s unvaccinated can contract tetanus, but older and immunocompromised people are at highest risk.
- Vaccination is the only way to prevent tetanus. Tetanus vaccines are nearly 100 percent effective and extremely safe, with a very low risk of serious side effects.
What is tetanus?
Tetanus is a painful and potentially deadly infection caused by bacteria living in dirt and soil. When the infection enters the bloodstream, it releases tetanus toxin, which targets the nerves that control your muscles. The bacteria can remain in your body for days or weeks before symptoms appear.
The earliest tetanus symptom is typically lockjaw, characterized by painful spasms in the jaw muscles that make it difficult to speak, swallow, and breathe. Lockjaw can cause severe pain and swelling and may last for days.
After lockjaw sets in, spasms travel down the body, affecting muscles in the neck, chest, abdomen, back, and lower body. Spasms tend to worsen over two weeks and can last for up to a month. In addition to muscle spasms, tetanus may cause fever, heart palpitations, and abnormally high or low blood pressure.
Most people with tetanus are hospitalized, and many require intensive care. Without appropriate treatment, tetanus can turn deadly, as muscle spasms in the neck and chest can impair breathing.
What causes tetanus?
Unlike many infectious diseases, like measles or the flu, tetanus doesn’t spread from person to person. Instead, the infection occurs when bacteria enter your bloodstream, typically through an open wound or unsanitary injection.
Many people believe that stepping on a rusty nail can cause tetanus. But the rust isn’t what poses a risk: it’s the bacteria that live on the nail and other contaminated surfaces. Even a brand-new nail that appears clean can harbor the bacteria that cause tetanus and lead to an infection.
Some common sources of tetanus exposure:
- Cuts or puncture wounds from unsanitized objects, including knives, piercing and sewing needles, and nails.
- Animal and (rarely) insect bites.
- Open wounds or burns contaminated by dirt, feces, or saliva.
- Contaminated needles, including those used in intravenous drug use, piercing, and tattoos.
How can you protect against tetanus?
A tetanus infection does not protect you from future infections, so vaccination is the only way to gain immunity.
DTaP, which contains full doses of the diphtheria, tetanus, and pertussis vaccines, is for infants and children under 11 years old. All infants and children should receive a total of five doses of DTaP at age 2 months, 4 months, 6 months, 15-18 months, and 4-6 years.
Tdap is a booster that contains a full dose of the tetanus vaccine and low doses of the diphtheria and pertussis vaccines. Adolescents get the booster at age 11 or 12.
The booster is also recommended during pregnancy, after potential tetanus exposure, and every 10 years for adults. Pregnant people should get the Tdap vaccine to protect their baby against both tetanus and whooping cough, which is very dangerous for infants. Non-pregnant adults have the option to receive a Td booster, which does not include a pertussis vaccine.
How effective are tetanus vaccines?
Tetanus vaccines are nearly 100 percent effective. The first modern tetanus vaccines were developed in the 1920s and 1930s. After World War II, the combination vaccine, which also protects against whooping cough (pertussis) and diphtheria, went into widespread use.
Vaccines, along with improved wound care and the introduction of antibiotics, resulted in a 95 percent reduction in tetanus cases and a 99 percent reduction in tetanus deaths in the U.S. since 1947.
There are currently three tetanus vaccines available in the U.S., depending on your age: DTaP (diphtheria, tetanus, and pertussis), Tdap (tetanus, diphtheria, and pertussis), and Td (tetanus and diphtheria). All three vaccines are nearly 100 percent effective at preventing tetanus.
Tetanus vaccine effectiveness wanes over time, requiring a booster every 10 years. Cases of tetanus in people who are up to date on their vaccinations are extremely rare.
Are tetanus vaccines safe?
Yes, all tetanus vaccines are rigorously tested for safety. There are no safety concerns associated with any tetanus vaccine currently in use. Mild side effects, such as a fever or headache, may occur, but serious side effects are extremely rare.
Like all vaccines, tetanus shots contain ingredients that make them safer and more effective. There are no “toxic” or harmful ingredients in the DTaP, Tdap, or Td vaccines. The full list of ingredients and their purpose has been publicly available for as long as the vaccines have been on the market.
For more information about tetanus vaccination, talk to your health care provider.