When Do You Need a Tetanus Shot?

If it’s been more than 10 years — or if you don’t remember — you may be due for the vaccine

Jessica Migala, AARP

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Published September 08, 2023

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If there’s one image that comes up when you think of tetanus, it might be a rusty nail. Indeed, maybe your mom yelled, Put on shoes, you don’t want to step on a rusty nail! And you did the same (or some version of that) with your kids.

Why? Well, it would hurt, for one. But you’d also need a tetanus shot.

And there’s truth to all those warnings: Tetanus is an infection caused by Clostridium tetani bacteria, which produce a toxin that when in your bloodstream acts on your nerves, causing involuntary muscle contractions, according to the Centers for Disease Control and Prevention.

The result is tightening, spasming and stiffness, especially in the jaw. Hence tetanus’ nickname, “lockjaw.” It can also make it difficult to swallow. Complications include trouble breathing, blood clots in the lung and aspiration pneumonia — serious stuff.

Despite the fact that tetanus cases have plummeted more than 99 percent since 1947, according to the CDC, tetanus still occurs, and it still kills. From 2009 to 2017, there were 264 cases and 19 deaths. Nearly one-quarter of cases were in people age 65 and older, while all deaths were in people over age 55.

If you have diabetes — as nearly one-third of Americans over age 65 do — your risk of infection is also higher, according to the National Academies of Sciences, Engineering, and Medicine. That’s why even with the low numbers of cases, vaccination remains important, especially with age.

“When older adults get any type of infection, they tend to have more serious outcomes because the immune system is naturally not as robust compared to when they were younger,” says June McKoy, M.D., a professor of medicine in geriatrics and preventive medicine at Northwestern Medicine in Chicago. As for tetanus specifically, doctors aren’t talking about the tetanus vaccine as much as they should, McKoy says.

So, it’s up to you to speak up. If you’re not sure whether you’re current on your tetanus shot, here’s what you need to know about the infection, when you might need the vaccine and how to get it.

How do you get tetanus?

Unlike many other diseases, tetanus is not spread from person to person. You pick up the bacteria from the environment — spores can live in dirt, feces, dust, spit, etc. — through a break in the skin. Even seemingly benign cuts, like from stepping on a sharp, dirty pebble or walking in grass that has dog poop (and we all know that’s easy to find), can transmit tetanus, McKoy says.

When it comes to vaccination, you’ll get a tetanus vaccine not on its own but as part of a routine Tdap vaccination. (Tdap stands for tetanus, diphtheria and pertussis.) Adults need a Tdap booster every 10 years, according to the CDC. Tetanus can also be given as Td, which offers protection against tetanus and diphtheria.

As data in the Journal of the American Geriatrics Society shows, a little more than half of older adults are caught up on their tetanus shots. If you’re part of that share and find yourself in a situation where you need emergency treatment — you stepped on a rusty nail or cut yourself on barbed wire, for example — your doctor may give you a tetanus booster, explains Linda Yancey, M.D., an infectious disease specialist at Memorial Hermann Katy Hospital in Katy, Texas. And if you’re in the hospital for a puncture wound, cut or burn, you may be given a medicine called tetanus immune globulin (TIG), which gives your body the antibodies it needs to protect against the infection.

One thing to note: Contracting tetanus won’t give you future immunity. So even if you’ve had it, you’ll still need to be vaccinated.

What to do if you have a wound

We all cut ourselves sometimes. Should that happen to you, clean the area well, apply a topical antibiotic ointment like bacitracin and contact your doctor, McKoy suggests.

Ask: Am I up to date with my tetanus shot? If you’re not or you know it’s been more than 10 years since your last one (or if you have no idea), you can arrange to see your doctor or walk into your pharmacy and ask for a Tdap or Td vaccine. You do not need a prescription.

As for side effects, the tetanus vaccine and the vaccines it’s bundled with are safe, though there may be some short-term discomfort from the shot itself. “I like to warn patients that with a tetanus booster, their arm might swell up and hurt,” Yancey says. If that happens to you, you can see that as a good thing. “Tetanus is one of the best vaccines we have; it’s highly efficacious,” she says.

Shoulder soreness doesn’t feel that great, but you can take it as a sign that the vaccine is doing its job. If you’d like to avoid the discomfort or other potential side effects, such as fever or headache, Yancey says you can take acetaminophen (Tylenol) or ibuprofen (Advil) for some relief.

As with any vaccine, if you have a history of an allergic reaction to a vaccine, talk to your doctor before being vaccinated.

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Jessica Migala has written for Marie Claire, Prevention and more than 30 other publications.

When Do You Need a Tetanus Shot?

If it’s been more than 10 years — or if you don’t remember — you may be due for the vaccine

How do you get tetanus?

What to do if you have a wound

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