Vaccination
Tetanus — When to Get a Booster
2025-08-20 • Updated 2025-08-29
Tetanus — When to Get a Booster
Intro
Tetanus is a rare but life-threatening bacterial disease caused by Clostridium tetani. The bacteria release a toxin that affects the nervous system, causing painful muscle spasms, lockjaw, breathing problems, and often death if untreated.
Vaccination and timely boosters are the best protection.
Key Points
- Adults need a routine booster every 10 years.
- If more than 5 years since last dose and a dirty or high-risk wound occurs, an additional booster is recommended.
- Childhood protection begins with DTaP vaccines in infancy, with Tdap boosters in adolescence and adulthood.
- Maternal vaccination during pregnancy protects newborns from neonatal tetanus.
Background
- History: Tetanus toxoid vaccines were introduced in the 1920s and became widespread after WWII, nearly eliminating the disease in high-income countries.
- Transmission: Tetanus is not contagious; spores live in soil and enter through cuts, punctures, or burns.
- Global picture: Routine vaccination and maternal programs have sharply reduced neonatal tetanus, but thousands of cases still occur in regions with low coverage.
Evidence
- Effectiveness: Near 100% protection with full vaccination and boosters.
- Population data: In high-coverage countries, tetanus is extremely rare. In low-resource settings, neonatal tetanus remains a serious problem.
- Safety: Tetanus vaccines have a long safety record; adverse effects are usually mild (injection site pain, low-grade fever).
Risks / Benefits
- Benefits: Prevents a disease with a very high fatality rate; enables elimination of neonatal tetanus when maternal coverage is high.
- Risks: Most adverse effects are mild and temporary. Serious reactions (e.g., anaphylaxis) are extremely rare.
- Myths: No evidence supports long-term risks such as infertility or autoimmune disease.
Global Recommendations
- WHO: Childhood vaccination (as part of DTP/DTaP schedule), with school-age, adolescent, and adult boosters. Maternal tetanus vaccination protects newborns.
- CDC (US): Tdap at 11–12 years, then Td/Tdap booster every 10 years. Extra dose if wound and >5 years since last shot.
- ATAGI (Australia): Routine doses at 2, 4, 6 months; 4 years; adolescence; and adult boosters every 10 years.
FAQ
Q: What if I don’t know when I had my last tetanus shot?
A: If you have a high-risk wound and it’s unclear, a booster is recommended.
Q: Is tetanus contagious?
A: No. It is acquired from the environment, not from other people.
Q: Do I still need boosters if I was vaccinated as a child?
A: Yes. Immunity wanes, so adult boosters are required.
Q: Why is neonatal tetanus still a problem in some countries?
A: Gaps in maternal vaccination and unhygienic birth practices.
Further Reading
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Last reviewed: August 29, 2025
Disclaimer
This guide is for educational purposes only and is not a substitute for professional medical advice.
Always consult a qualified healthcare provider for diagnosis, treatment, and personal medical advice.
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