How to Know when You Need a Tetanus Shot

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1 Knowing When to Get a Tetanus Shot

2 Learning About and Recognizing Tetanus

3 Treating Tetanus

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Co-authored by Tiffany Jumaily, MD and Carmine Shannon

Last Updated: June 13, 2024 Fact Checked

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Many people are familiar with the tetanus shot, but do you know when you should get the vaccine? Cases of tetanus in the U. S. and the rest of the industrialized world are rare due to high rates of vaccination. Vaccination is important, since there is no cure for tetanus, a disease caused by a bacterial toxin found in the soil, dirt, and animal feces. This toxic bacteria forms spores that are very difficult to kill since they are resistant to heat and many drugs and chemicals. Tetanus affects the nervous system and causes painful muscle contractions, particularly of the jaw and neck muscles. It can also hinder breathing, making it potentially deadly. For these reasons, it's important to understand when you should be vaccinated.

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Part 1

Part 1 of 3:

Knowing When to Get a Tetanus Shot

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1. 1
   Get a tetanus booster shot after getting a deep or contaminated wound. Usually, the bacterial toxins enter the body through a break in the skin caused by an object contaminated with tetanus. If you have one or more of the following injuries or wounds that are prone to tetanus, get a tetanus booster shot. These include:

   • Any wound visibly contaminated with soil, dust, rust, saliva, or horse manure.
   • Puncture wounds. Objects that can cause these types of wounds include wood splinters, nails, needles, glass, and human or animal bites.
   • Skin burns. Second-degree (partial-thickness or with blisters) and third-degree (full-thickness) burns are at higher risk for tetanus infection than first-degree (superficial) burns.
   • Crush injuries that damage tissue by squeezing it between two heavy objects. They can also happen when heavy objects are dropped onto parts of the body.
   • Wounds involving necrotic, or dead, tissue. This kind of tissue has no blood supply, increasing its risk for infection (along with severely compromised tissue). For example, areas of gangrene (dead body tissue) are at increased risk for infection.
   • Wounds with foreign objects in them. Wounds that have foreign bodies, such as splinters, glass shards, gravel, or other objects in them are at higher risk for infection.
2. 2
   Get a tetanus shot if you’re not up-to-date on your vaccines. If you never received the first series of tetanus shots (primary vaccination series) or you're not sure when you had your last tetanus shot, go get a tetanus shot. Also, get a booster If you’re injured in any of the following ways:

   • Your wound was caused by a “clean” object, but your last tetanus shot was over 10 years ago.
   • Your wound was caused by a “dirty” object and your last tetanus shot was more than 5 years ago.
     • A dirty, or contaminated, object has dirt/soil, saliva, or feces/manure on it, while a clean object does not. However, you can't necessarily know if an object has bacteria on it by looking at it.
   • You're not sure if the wound was caused by a “clean” or “dirty” object and your last tetanus shot was over 5 years ago.
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3. 3
   Get the shot while pregnant. In order to transfer tetanus antibodies to your baby, get a tetanus vaccine when you are between 27 and 36 weeks pregnant.

   • Your doctor will likely recommend the inactivated Tdap (Tetanus, Diptheria, and Pertussis) vaccine during the third trimester of your pregnancy.
   • If you have not had the Tdap vaccine before and don't have it during pregnancy, get vaccinated immediately after giving birth. Anyone else interacting with your baby also needs a Tdap vaccine at least two weeks before seeing them.
   • If you get a dirty cut or wound while pregnant, absolutely get a tetanus booster shot.
4. 4
   Get a round of tetanus shots to become immunized. The best way to "treat" tetanus is to prevent it in the first place. Several vaccines protect against tetanus. They are:

   • DTaP. The diphtheria, tetanus, and pertussis (whooping cough) vaccine (DTaP) are usually given to babies at ages 2, 4, and 6 months, then again at 15 to 18 months old, and finally once more between ages 4 and 6. DTap is a very effective vaccine for small children.
   • Tdap. Over time, protection from tetanus decreases, so older children need to get a booster shot. It has a full dose of tetanus and lower amounts of diphtheria and pertussis. All people between the ages of 11 and 18 are advised to get the booster, preferably around 11 or 12 years old.
   • Td. If you're an adult, get a Td (tetanus and diphtheria) booster shot every 10 years to stay protected. Since some people may lose the protective antibody levels after 5 years, a booster vaccination is recommended if you get a deep, contaminated wound and haven't had a vaccination in more than 5 years, even if you’ve had the full round of childhood immunizations.
   • Most people don't experience serious reactions to the vaccine, but there are a few common mild reactions. These include localized swelling, tenderness, and redness at the injection site, but these often clear up in 1-2 days.
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Part 2

Part 2 of 3:

Learning About and Recognizing Tetanus

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1. 1
   Learn how tetanus is contracted and spread. Tetanus is spread by bacterial spores that usually enter the body through a puncture. The spores make a powerful neurotoxin that can cause muscle spasms and stiffness. Tetanus is not, however, spread from person to person, unlike other vaccine-preventable diseases.

   • Nearly all cases of tetanus occur when someone isn’t up to date on their shots. Tetanus is preventable with vaccines, so if you’re unvaccinated or haven’t kept up with your 10-year boosters, you are at a higher risk of tetanus.
     • Complications from tetanus are highest among people who have not been immunized at all or in older adults with inadequate immunization in industrialized countries.
   • You may also be at increased risk of tetanus after a natural disaster, especially if you live in a developing country.
2. 2
   Disinfect your wounds to reduce your risk for tetanus. As soon as you get an injury or wound, wash your hands with soap and water, then clean and disinfect the area. If you delay disinfecting the new wounds by more than 4 hours, you increase the chances of tetanus infection.

   • This is even more important if the wound was caused by an object that punctured the skin, which can force bacteria and debris deep into the wound, making it an ideal environment for the growth of bacteria.
   • Pay attention to whether the object that caused your wound is clean or dirty to decide whether you need a tetanus booster.
3. 3
   Seek care if you develop tetanus symptoms. The incubation period varies from 3 to 21 days, with an average of 8 days. Tetanus severity is determined on a scale from I through IV. The longer it takes symptoms to appear, the more mild the disease is likely to be. The symptoms of tetanus (in order of appearance) include:

   • Spasm of jaw muscles (commonly referred to as “lockjaw”)
   • Stiffness of the neck
   • Difficulty swallowing (dysphagia)
   • Board-like rigidity of the abdominal muscles
4. 4
   Recognize other symptoms of tetanus. There are no blood tests that can diagnose tetanus, so it's important to pay attention to any symptoms. You may also notice fever, sweating, elevated blood pressure, or rapid heart rate (tachycardia). Possible complications include:

   • Laryngospasm, or spasm of the vocal cords, which can make breathing difficult
   • Bone fractures
   • Seizures/convulsions
   • Abnormal heart rhythms
   • Secondary infections, such as pneumonia, as a result of prolonged hospitalization
   • Pulmonary embolism, or blood clots in the lungs
   • Death (10% of reported cases are fatal)
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Part 3

Part 3 of 3:

Treating Tetanus

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1. 1
   Get medical attention. If you think or even suspect you have tetanus, seek medical treatment immediately. It's a medical emergency and you'll need to be hospitalized because tetanus has a high mortality, or death, rate (10%).

   • In the hospital, you'll be given a tetanus antitoxin, like tetanus immune globulin. This will neutralize any toxin that hasn't already bound to your nervous tissue. The wound will be thoroughly cleaned and you'll get a tetanus vaccine to prevent future infections.
   • Being infected with tetanus does not give you immunity from future infection. Instead, you'll need to get the tetanus vaccine to keep from getting it again.
2. 2
   Have a doctor determine your course of treatment. Since there are no blood tests that can diagnose tetanus, lab testing is not useful in the evaluation of the disease. Because of this, most doctors opt for aggressive treatment if infection is suspected, instead of taking a “wait and see” approach.

   • Doctors base their diagnosis mainly on the symptoms and clinical signs that are present. The more severe the symptoms, the more rapid the course of action.
3. 3
   Treat the symptoms of tetanus. Since there is no cure for tetanus, treatments are directed at symptoms and emerging complications. Symptoms are treated with antitoxins; antibiotics given intravenously, by injection, or orally; and other drugs to control muscle spasms.

   • Some of the drugs to control muscle spasms include sedatives from the benzodiazepine group (like diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax), and midazolam (Versed).
   • Antibiotics are not generally effective against tetanus, but they may be prescribed to keep the Clostridium tetani bacteria from reproducing. This can help slow the production of toxins.
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Expert Q&A

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• Question

  Is it safe to go into a flood disaster area if I have had a tetanus shot in the past five or six years?

  

  Chris M. Matsko, MD
  Family Medicine Physician

  Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.

  

  Chris M. Matsko, MD

  Family Medicine Physician

  Expert Answer

  Yes, it should be safe, but you may want to check with your doctor about any other vaccinations that you may need, especially if this is in a foreign country.

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• Question

  I was recently cut by glass. Do I need a tetanus shot for this?

  

  Chris M. Matsko, MD
  Family Medicine Physician

  Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.

  

  Chris M. Matsko, MD

  Family Medicine Physician

  Expert Answer

  You doctor may offer you a tetanus shot if you were cut by glass and you cannot remember when you had your last booster. If you cut requires stitches, I would recommend you get the shot.

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  If wikiHow has helped you, please consider a small contribution to support us in helping more readers like you. We’re committed to providing the world with free how-to resources, and even $1 helps us in our mission. Support wikiHow

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Tips

• A couple of rare diseases can cause similar symptoms to tetanus. Malignant hyperthermia is an inherited disease that causes a rapid onset of fever and severe muscle contractions when you have general anesthesia. Stiff Person Syndrome is an extremely rare disease of the nervous system that causes periodic muscle spasms. Symptoms usually begin in your mid-40s.
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• There are tetanus vaccines that can also protect against Diphtheria and Pertussis (Tdap) or only Diphtheria (Td). Both vaccines last 10 years.
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• The date of your last tetanus booster should be found in your immunization records at your doctor's office. Some people carry a personalized card verifying their dates of immunization, which you can get from your doctor.
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The advice in this section is based on the lived experiences of wikiHow readers like you. If you have a helpful tip you’d like to share on wikiHow, please submit it in the field below.

• After you get the vaccine or boosters, expect serious swelling. This is only for some people who have stronger reactions to some of the chemicals in the injection. The swelling should go down within two to three days. If it doesn't go away, seek medical help immediately.
• Throw away any old rusty objects you have at home so you don't accidentally hurt yourself and contract tetanus.

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Warnings

• Seek medical attention for any serious wounds or injuries. If you suspect that you have been infected with the tetanus bacteria, do not wait for symptoms to become present before getting proper treatment. There is no cure for tetanus, only treatment of symptoms until they resolve.
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