Tetanus Vaccine

November 21, 2009

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Tetanus Vaccine

by Lynn Cates, M.D., F.A.A.P.
reviewed by Laura Jana, M.D., F.A.A.P.

The vaccine that prevents tetanus tetanus is one of the oldest and safest vaccines available. This vaccine was first introduced in 1924 and was responsible for saving many soldiers' lives in World War II. It has been used routinely in children in the United States since the late 1940s. You may have heard recently that there is a temporary shortage of tetanus vaccine. Please see our article "Tetanus Vaccine Shortage" for more information.

What is in the tetanus vaccine?
Like the diphtheria vaccine, the tetanus vaccine is a toxoid. Toxoid vaccines are made by treating the toxins (or poisons) produced by the germ that causes the disease (in this case /Clostridium tetani) with heat or chemicals, such as formalin. While this process destroys the toxin's ability to cause illness, the toxin is still able to stimulate the immune system to produce protective antibodies. Exposing someone to this inactive form of tetanus toxin allows her body's defense system to be prepared if she ever encounters the actual disease.

How well does the vaccine work?
The tetanus vaccine protects almost everyone who has received the full series of recommended doses. Since this vaccine has been used routinely in children, the number of people with tetanus has fallen from 400 to 500 per year, to about 50.

When should tetanus vaccine be given?

Infants and young children. Tetanus vaccine is almost always given to infants and young children combined with diphtheria toxoid (D) and acellular pertussis (aP) vaccines as the DTaP shot. Children should receive a total of five doses of DTaP by the time they are four to six years old (doses at two months, four months, six months, twelve to eighteen months, and four to six years). For the full schedule of routine childhood immunizations, please refer to our article, "Immunization Schedules."

Older children and adults. Booster shots for tetanus should be given at 11 to 12 years of age, and then every 10 years after that to maintain lifetime immunity. They also should receive a booster if they have a potentially contaminated wound and it has been more than five years since their last dose. Children age seven years and older should receive the adult preparation of the combined diphtheria and tetanus vaccine, which has a smaller amount of diphtheria vaccine than is used in younger children. Because pertussis vaccine is not licensed for children seven years or older, they are not given the DTaP vaccine that younger children routinely receive. The combined diphtheria and tetanus vaccine is also known as TD or Td. When a person receives a "tetanus" booster, it usually is Td, not just tetanus toxoid.

Pregnant women. Tetanus toxoid and Td are safe to get during pregnancy. Women who have been fully immunized should have a Td booster if it has been more than 10 years since their last dose. If they have a wound that could be contaminated, they should have a booster if it has been more than five years since the last dose. Optimally, if a pregnant woman is not fully immunized against tetanus, she should receive two doses of tetanus toxoid or Td four weeks apart. In order to provide sufficient time for the mother to make antibodies and transfer them to her baby across the placenta, she needs to have received both doses at least two weeks before she gives birth.

Survivors of tetanus disease. Unfortunately, people who get tetanus disease do not make protective antibodies, so they still need to be immunized as soon as they start to recover.

What are the side effects of tetanus vaccine?
Tetanus disease is much riskier than getting tetanus vaccine, whether the tetanus toxoid is given alone or in combination as Td or DTaP. Tetanus toxoid is one of the safest vaccines known. Severe reactions are extremely rare. Since tetanus vaccine usually is administered in combination, please see our articles on Td and DTaP for more information on risks of these vaccines.

Adapted from information provided by the National Immunization Program (NIP) of the Centers for Disease Control and Prevention (CDC).


RELATED INFORMATION

			Diphtheria Vaccine
			Tetanus
			Immunizations: General

Created August 07, 2001
Reviewed August 09, 2001

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