Vaccines All About Tetanus Shots Who Needs Them and Who Doesn't By Kristina Duda, RN Kristina Duda, RN Facebook LinkedIn Twitter Kristina Duda, BSN, RN, CPN, has been working in healthcare since 2002. She specializes in pediatrics and disease and infection prevention. Learn about our editorial process Updated on June 16, 2021 Medically reviewed by Anju Goel, MD, MPH Medically reviewed by Anju Goel, MD, MPH LinkedIn Anju Goel, MD, MPH, is a board-certified physician who specializes in public health, communicable disease, diabetes, and health policy. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Diseases Treated Recommendations Side Effects Precautions and Contraindications 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: DT, given to children 2 months to 6 years to prevent diphtheria and tetanus 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 Iab Wooten / Getty Images 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. Top 20 Vaccines You Should Know About 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-mL dose and given five times between the ages of 2 months and 4 to 6 years. ACIP recommends the following immunization schedule: 2 months4 months6 months15 to 18 months4 to 6 years What You Need to Know About the DTaP Vaccine Can DTaP Cause Brain Disease? Historically, there was concern that the pertussis vaccine could cause a brain disease called encephalopathy. Although evidence supported the possibility, this was never proven. Furthermore, the risk was associated with the whole-cell pertussis vaccine—not the acellular pertussis vaccine used in DTaP. The United States switched from the whole-cell pertussis vaccine to the acellular pertussis vaccine in the 1990s due to this and other safety concerns. DT Vaccination DT is used in the same way as the DTaP vaccine. However, it is only used in children who should not get pertussis vaccines, such as those who have had a severe allergic reaction to a dose of DTaP. Parents should remember, though, that children vaccinated with DT are only protected against diphtheria and tetanus, not whooping cough. Tdap and Td Vaccinations After 6 years of age, your child ages out of the DTaP vaccine and will receive the Tdap vaccine. 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 may be Tdap or the Td vaccine, so long as they have received Tdap in the past; if not, at least one booster should be Tdap. Tdap differs from DTaP in the size of the dose of each of the three vaccines. With Tdap, the tetanus dose is the same as DTaP but the diphtheria and pertussis doses are smaller. One Tdap dose is also recommended during each pregnancy regardless of when someone was last vaccinated against tetanus. The Td or Tdap vaccine, also administered by intramuscular injection in a 0.5 milliliter (mL) dose, is also recommended for anyone who has an injury or wound that could possibly cause tetanus who has not had a tetanus vaccine of any kind in the past five years. What You Need to Know About the Tdap Vaccine 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. The Facts About Vaccine Side Effects Precautions and Contraindications There are certain people in whom the Td, Tdap, DT, 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). Vaccines Healthcare Provider Discussion Guide Get our printable guide for your next healthcare provider's appointment to help you ask the right questions. Download PDF Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. 10 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. Diphtheria, tetanus, and pertussis vaccines. Centers for Disease Control and Prevention. Tetanus: For clinicians. Centers for Disease Control and Prevention. Diphtheria. Kilgore PE, Salim AM, Zervos MJ, Schmitt HJ. Pertussis: Microbiology, disease, treatment, and prevention. Clin Microbiol Rev. 2016;29(3):449-86. doi:10.1128/CMR.00083-15 Liang JL, Tiwari T, Moro P, et al. Prevention of pertussis, tetanus, and diphtheria with vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2018;67(2):1-44. doi:10.15585/mmwr.rr6702a1 Klein NP. Licensed pertussis vaccines in the United States: history and current state. Hum Vaccin Immunother. 2014 Sep;10(9):2684-90. doi:10.4161/hv.29576 Centers for Disease Control and Prevention. Diphtheria, tetanus, and whooping cough vaccination: What everyone should know. Centers for Disease Control and Prevention. Pertussis: Summary of vaccine recommendations. Havers FP, Moro PL, Hunter P, Hariri S, Bernstein H. Use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines: Updated recommendations of the Advisory Committee on Immunization Practices — United States, 2019. MMWR. 2020;69:77-83. doi:10.15585/mmwr.mm6903a5 McNeil MM, Weintraub ES, Duffy J, et al. Risk of anaphylaxis after vaccination in children and adults. J Allergy Clin Immunol. 2016 Mar;137(3):868-78. doi:10.1016/j.jaci.2015.07.048 By Kristina Duda, RN Kristina Duda, BSN, RN, CPN, has been working in healthcare since 2002. She specializes in pediatrics and disease and infection prevention. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit