How Often Do I Need a Tetanus Booster Shot?

Current Recommendations and Practices

If you haven't had a tetanus booster shot in the past decade, you're probably overdue. A booster every 10 years is recommended.

Doctor giving a patient a shot
IAN HOOTON / Getty Images

Tetanus shots are not just tetanus shots, however. They're almost always bundled with another vaccine (unless you're getting the shot because of a deep, dirty cut or something similar.)

It's not just rusty nails that you have to worry about, either. The bacteria that causes tetanus is found in many parts of the environment and you can be exposed through any open wound. That's why it's important to stay up to date on your booster shots.

What Is a Tetanus Shot?

A tetanus shot is a vaccine to protect against the bacteria that causes tetanus, a disease that affects the nervous system. The shot is typically bundled with at least one other vaccine. There are four versions: DTaP or DT for children under age 7, and TDaP and Td are booster vaccines for older children and adults.

According to the Centers for Disease Control and Prevention (CDC), tetanus is rare in the United States. Only around 30 cases are reported each year, almost all of which involve adults who were never vaccinated or given their 10-year booster.

The Schedule of DTaP Shots for Kids
Verywell / JR Bee

About Tetanus

Tetanus, also known as lockjaw, is from a bacteria called Clostridium tetani that are found in soil, dust, and manure. The spores are produced by the C. Tetani bacteria and the bacteria grow after entering in the body to cause disease.

The disease affects the nervous system and leads to muscle spasms. It doesn't just lock your jaw closed, but that is the most widely known symptom. Besides not being able to open your mouth, tetanus can make swallowing difficult and cause neck stiffness.

Additionally, some people experience muscle cramps in the abdomen. These spasms will be in the muscles of the abdominal wall and not in the gut like other types of cramps.

After exposure, it can take anywhere from three to 21 days for symptoms to develop. The timing depends largely on the extent and duration of contamination of a wound. The average incubation period is 10 days.

If left untreated, tetanus can lead to seizures. It causes death in between 10% and 20% of people with untreated, symptomatic disease, primarily older people.

Booster Recommendations

The most common vaccines included with tetanus are diphtheria and pertussis, better known as whooping cough. These used to be referred to as DPT shots (diphtheria, pertussis, and tetanus). More recently, they've been referred to as:

  • DTaP (diphtheria, tetanus, and acellular pertussis), which is used for the initial vaccination
  • Tdap (tetanus, diphtheria, and acellular pertussis), which is used for boosters
  • Td (tetanus and diphtheria), which also is used for boosters

Boosters are what you get after you received the first vaccination series as a kid. Every 10 years, you should get a tetanus booster from your doctor, either the Tdap or the Td.

Due to the rise of whooping cough—in California especially—doctors have been giving Tdap shots to teens and adults at least once during their routine 10-year booster schedule. Normally, booster shots are for tetanus and diphtheria alone.

Public health authorities also recommend a booster shot if you get a particularly nasty open wound and it's been five years or more since your last tetanus shot.

Depending on how bad the injury is, you may also get a straight shot of the tetanus vaccine without the other vaccines.

Immunization Schedule

The first DTaP immunizations start when children are between 6 weeks and 2 months old. The schedule of DTaP shots for young children typically follows this guideline:

  • 2 months
  • 4 months
  • 6 months
  • 15 to 18 months (could be as early as 12 months)
  • 4 to 6 years (right around the start of kindergarten)

Adolescents get a booster Tdap shot at around 11 to 12 years. If they miss this, it's okay for them to get a Tdap between 13 and 18 years.

It's recommended that adults get a Tdap shot for one of their tetanus boosters. If you're over 65, you may not need the Tdap shot but can get one if your doctor believes it appropriate.

Transmission Risk

Many of us were taught that you get tetanus from rusty nails, but it has more to do with the dirt on the nail than the rust. Since the spores that develop into tetanus are everywhere, you can get the disease in a lot of ways.

The spores of C. tetani commonly found in soil and animal feces can remain inactive but infectious for up to 40 years. The spores can get into your body through any break in the skin, including cuts, punctures, burns, animal and/or human bites, and crush injuries.

In rare cases, tetanus may occur in:

  • Chronic sores and infection
  • Clean superficial wounds in which the top layer of skin is removed
  • Compound fractures
  • Insect bites
  • Intramuscular injections
  • Intravenous drug use
  • Surgical or dental procedures

Public health authorities will often offer tetanus boosters after a natural disaster, including floods. This is a cautionary measure the mitigate the increased risk of tetanus infection.

The good news is that you can't get tetanus from someone else because it's not a contagious disease.

A Word From Verywell

The advice to keep up to date on your tetanus boosters is given for a very good reason: Tetanus is a serious disease that can be caused by a wide variety of factors.

If you do get a cut worthy of stitches, you might need to have a tetanus shot, too. The doctor that treats you should be able to decide whether you need the shot. If they offer one, it is probably a good idea to take it.

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Article Sources
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  1. Centers for Disease Control and Prevention. Who Should Get Diphtheria Tetanus, and Whooping Cough Vaccines? Reviewed December 17, 2018.

  2. Hassel B. Tetanus: pathophysiology, treatment, and the possibility of using botulinum toxin against tetanus-induced rigidity and spasms. Toxins (Basel). 2013;5(1):73–83. Published 2013 Jan 8. doi:10.3390/toxins5010073

  3. Centers for Disease Control and Prevention. Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis (Tdap) Vaccine in Adults Aged 65 Years and Older -- Advisory Committee on Immunization Practices (ACIP), 2012. Published June 29, 2012.

  4. Finkelstein P, Teisch L, Allen CJ, Ruiz G. Tetanus: A Potential Public Health Threat in Times of Disaster. Prehosp Disaster Med. 2017;32(3):339–342. doi:10.1017/S1049023X17000012

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