Skip to main content

Tetanus and Adults

Tetanus, commonly called lockjaw, is caused by a bacterial toxin, or poison, that affects the nervous system. It enters the body through a cut or wound. The bacteria can get in through even a tiny pinprick or scratch, but deep puncture wounds or cuts like those made by nails or knives make it especially easy for tetanus to enter the body. Tetanus bacteria are in every part of the world and are commonly found in soil, dust, and manure. Tetanus is not transmitted from person to person.


Tetanus causes severe muscle spasms, including “locking” of the jaw so the patient cannot open his or her mouth or swallow, and may lead to death by suffocation. Common first signs of tetanus include muscular stiffness in the jaw followed by stiffness of the neck, difficulty in swallowing, rigid abdominal muscles, generalized spasms, sweating, and fever. Symptoms usually begin about seven days after bacteria enter the body, but the symptoms may start as soon as three days or as long as three weeks later.


Vaccination is the only way to protect against tetanus. Due to widespread immunization, tetanus is now a rare disease in the US. A combination booster vaccine, called Tdap, protects against tetanus, diphtheria, and pertussis (whooping cough). Tdap should be given to all adults once in place of one Td (tetanus-diphtheria) booster vaccine, which is recommended every 10 years. Adults who were never fully immunized against tetanus should start with a three-dose primary series given over seven to 12 months.

Which adults should get vaccinated against tetanus?

  • Those who did not receive a primary immunization series during childhood.
  • Those who have not received a Td/Tdap booster dose within the past 10 years.
  • Older adults and diabetics, who are at higher risk for tetanus, should carefully review their history of tetanus immunization and receive Td or Tdap if they have not had a booster vaccine in the last 10 years.
  • Any adult who has recovered from tetanus (lockjaw) disease should receive Tdap or Td.
  • Special note: Adults who have not already received Tdap should get a single Tdap dose in place of one Td booster.
  • All healthcare professionals and persons in contact with infants younger than one year of age should also receive Tdap vaccine to protect against pertussis (whooping cough).

Vaccine Safety

The Td vaccine is very safe, and very few people experience any side effects. When side effects do occur, they are usually soreness, redness, or swelling at the injection site, and a slight fever. As with any medicine, there are very small risks that serious problems could occur after getting the vaccine. The potential risks associated with tetanus are much greater than the potential risks associated with the vaccines. You cannot get tetanus from the vaccine.

Disease and Vaccine Facts

  • FACT: Tetanus can be prevented with safe and effective vaccines.
  • FACT: You cannot get tetanus from the vaccines.
  • FACT: Tetanus is caused by a toxin produced by bacteria found worldwide in soil, dust, and manure.
  • FACT:  Tetanus is not transmitted from one person to another; vaccination provides protection of the vaccinated individual only.
  • FACT:  Almost all reported cases of tetanus occur in people who either have never received the primary series of tetanus vaccines, or those who completed a primary series, but have not had a booster vaccination in the past 10 years.
  • FACT: Approximately 10 to 20 percent of reported cases of tetanus are fatal.
  • FACT:  In the US, where 50 or fewer cases of tetanus occur each year, deaths are more likely to occur in persons age 60 years and older and in persons who are diabetic.
  • FACT: People with tetanus may have to spend several weeks in the hospital under intensive care and frequently need to be on a ventilator.
  • FACT: For adults, a tetanus-diphtheria booster (Td) every 10 years gives protection against both tetanus and diphtheria. A tetanus-diphtheria-acellular pertussis (Tdap) vaccine should be given to adults in place of one Td vaccine to protect them against pertussis (whooping cough), too.
  • FACT:  Recovery from tetanus may not result in immunity. Patients recovering from tetanus should be vaccinated soon after their condition has stabilized