Is 5 days too late for tetanus shot

Healthdirect Free Australian health advice you can count on.

Key facts

• Tetanus is a serious bacterial infection that affects the nerves in the brain and spinal cord, causing painful muscle spasms throughout the body.
• Because of vaccination, few people now get tetanus in Australia.
• Tetanus bacteria live mainly in soil, dust and manure, but can be found anywhere.
• You can become infected if the bacterium enters your bloodstream through an open wound.
• Tetanus can be prevented with vaccination, but immunity lessens over time, so booster doses are needed to ensure you are protected.

What is tetanus?

Tetanus is a serious bacterial infection that affects the nerves in the brain and spinal cord, causing painful muscle spasms throughout the body. It is often fatal. Because of vaccination, few people now get tetanus in Australia. Everybody should be vaccinated and have boosters at the correct time throughout life.

Tetanus is sometimes known as 'lock jaw', because it typically causes spasms of the jaw making it close firmly (lock).

What are the symptoms of tetanus?

Symptoms of tetanus include:

• painful muscle spasms, especially in the face or neck, that can last for several minutes
• a locked jaw (not being able to open the mouth)
• difficulty talking and swallowing
• difficulty breathing
• rapid heartbeat
• fever

Symptoms usually take 3 to 21 days to show after infection.

Tetanus is often fatal.

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What causes tetanus?

Tetanus is caused by infection with a bacterium called clostridium tetani (c. tetani). The bacteria produce a toxin (poison), which attacks the nervous system. This leads to muscle spam.

C. tetani live mainly in soil, dust and manure, but can be found anywhere. You can become infected if the bacterium enters your bloodstream through an open wound, such as:

• any wound that is not clean
• a bite from an animal or human
• any wound that pierces the skin, such as a scratch from a rusty nail

Even something as minor as a prick from a rose thorn can become infected with c. tetani, but some wounds are more likely to become infected, for example if:

• they are very deep
• they contain a foreign body such as a splinter
• the wound is over a broken bone (a compound fracture)

You are more at risk of tetanus if there is a lot of pus, damage to the tissues (such as with a burn) or if the wound has been contaminated with soil, dust or manure.

You cannot catch c. tetani or tetanus itself from other people.

When should I see my doctor?

You should see your doctor if you have a wound that is dirty, or a wound where the skin has been penetrated (such as a wound from a rose thorn or from a rusty nail).

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How is tetanus diagnosed?

Your doctor can diagnose tetanus by examining recent wounds that have been in contact with soil, checking for symptoms like stiff neck and jaw, and asking you when you last had a tetanus booster.

How is tetanus treated?

Treatment will vary depending on the severity of the symptoms. People with mild symptoms will be given a tetanus antitoxin and antibiotics.

People who have severe symptoms will be admitted to hospital to treat breathing and muscle paralysis.

Can tetanus be prevented?

Tetanus can be prevented with vaccination (commonly known as a tetanus shot), but immunity lessens over time, so booster doses are needed to ensure you are protected.

The tetanus vaccine is given as part of routine childhood immunisation under the National Immunisation Program. It is given free of charge at 6 weeks to 2 months, 4 months, and again at 6 months old. Booster vaccinations are recommended at 18 months and 4 years.

Older children are usually given an additional booster vaccination between 11 and 13 years. You may also need a booster if you are going travelling or if you are injured.

After the complete course of tetanus vaccinations, another booster is usually recommended for people at age 50 and again at age 65, if it has been more than 10 years since the last dose. If you are unsure whether your tetanus vaccination is up to date, see your doctor. It is never too late.

Tetanus vaccine

Vaccination is your best protection against tetanus. This table explains how the vaccine is given, who should get it, and whether it is on the National Immunisation Program Schedule.

Resources and support

For more information about tetanus, visit the Department of Health and Aged Care information page on tetanus and getting vaccinated.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Tetanus

Overview

Tetanus is a serious disease of the nervous system caused by a toxin-producing bacterium. The disease causes muscle contractions, particularly of your jaw and neck muscles. Tetanus is commonly known as lockjaw.

Severe complications of tetanus can be life-threatening. There's no cure for tetanus. Treatment focuses on managing symptoms and complications until the effects of the tetanus toxin resolve.

Because of the widespread use of vaccines, cases of tetanus are rare in the United States and other parts of the developed world. The disease remains a threat to people who aren't up to date on their vaccinations. It's more common in developing countries.

Symptoms

The average time from infection to appearance of signs and symptoms (incubation period) is 10 days. The incubation period can range from 3 to 21 days.

The most common type of tetanus is called generalized tetanus. Signs and symptoms begin gradually and then progressively worsen over two weeks. They usually start at the jaw and progress downward on the body.

Signs and symptoms of generalized tetanus include:

• Painful muscle spasms and stiff, immovable muscles (muscle rigidity) in your jaw
• Tension of muscles around your lips, sometimes producing a persistent grin
• Painful spasms and rigidity in your neck muscles
• Difficulty swallowing
• Rigid abdominal muscles

Progression of tetanus results in repeated painful, seizure-like spasms that last for several minutes (generalized spasms). Usually, the neck and back arch, the legs become rigid, the arms are drawn up to the body, and the fists are clenched. Muscle rigidity in the neck and abdomen may cause breathing difficulties.

These severe spasms may be triggered by minor events that stimulate the senses a loud sound, a physical touch, a draft or light.

As the disease progresses, other signs and symptoms may include:

• High blood pressure
• Low blood pressure
• Rapid heart rate
• Fever
• Extreme sweating

Localized tetanus

This uncommon form of tetanus results in muscles spasms near the site of a wound. While it's usually a less severe form of disease, it can progress to generalized tetanus.

Cephalic tetanus

This rare form of tetanus results from a head wound. It results in weakened muscles in the face and spasms of the jaw muscles. It also can progress to generalized tetanus.

When to see a doctor

Tetanus is a life-threatening disease. If you have signs or symptoms of tetanus, seek emergency care.

If you have a simple, clean wound and you've had a tetanus shot within 10 years you can care for your wound at home.

Seek medical care in the following cases:

• You've not had a tetanus shot within 10 years.
• You are unsure of when you last had a tetanus shot.
• You have a puncture wound, a foreign object in your wound, an animal bite or a deep cut.
• Your wound is contaminated with dirt, soil, feces, rust or saliva or you have any doubt about whether you've cleaned a wound sufficiently after such exposure. Contaminated wounds require a vaccination booster if it's been five or more years since your last tetanus shot.

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Causes

The bacterium that causes tetanus is called Clostridium tetani. The bacterium can survive in a dormant state in soil and animal feces. It's essentially shut down until it discovers a place to thrive.

When the dormant bacteria enter a wound a condition good for growth the cells are "awakened." As they are growing and dividing, they release a toxin called tetanospasmin. The toxin impairs the nerves in the body that control muscles.

Risk factors

The greatest risk factor for tetanus infection is not being vaccinated or not keeping up with the 10-year booster shots.

Other factors that increase the risk of tetanus infection are:

• Cuts or wounds exposed to soil or manure
• A foreign body in a wound, such as a nail or splinter
• A history of immune-suppressing medical conditions
• Infected skin lesions in people living with diabetes
• An infected umbilical cord when a mother isn't fully vaccinated
• Shared and unsanitary needles for illegal drug use

Complications

Complications of tetanus infection may include:

• Breathing problems. Life-threatening breathing problems can occur from tightening of the vocal cords and muscle rigidity in the neck and abdomen, especially during a generalized spasm.
• Blockage of a lung artery (pulmonary embolism). A blood clot that has traveled from elsewhere in your body can block the main artery of the lung or one of its branches.
• Pneumonia. A lung infection caused by accidentally inhaling something into the lungs (aspiration pneumonia) may be a complication of generalized spasms.
• Broken bones. Generalized spasms may cause fractures of the spine or other bones.
• Death. Death from tetanus is often caused by a blocked airway during spasms or damage to the nerves that regulate breathing, heart rate or other organ functions.

Prevention

You can prevent tetanus by being vaccinated.

Vaccination for children

The tetanus vaccine is given to children as part of the diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). Diphtheria is a serious bacterial infection of the nose and throat. Acellular pertussis, also called whooping cough, is a highly contagious respiratory infection.

Children who do not tolerate the pertussis vaccine may receive the alternative vaccine called DT.

The DTaP is a series of five shots typically given in the arm or thigh to children at ages:

• 2 months
• 4 months
• 6 months
• 15 to 18 months
• 4 to 6 years

Vaccination for children ages 7 to 18

A booster shot is recommended for children at age 11 or 12. This booster is called the Tdap vaccine. If your child didn't get a booster shot as this age, talk to your doctor about appropriate options.

Vaccination for adults age 19 and older

A booster shot is recommended for adults once every 10 years. This may be one of two vaccines, Tdap or Td. If you weren't vaccinated against tetanus as a child or are unsure about your vaccination status, see your doctor about getting the Tdap vaccine.

Vaccination during pregnancy

A booster is recommended during the third trimester of a pregnancy, regardless of the mother's vaccination schedule.

Other recommendations

• Ask your doctor to review your vaccination status regularly.
• Check whether you are current on your vaccination schedule if you are planning international travel.

Dec. 21, 2023