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Harvard Medical School
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General Medical Questions
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Question : How soon after an injury should you have a tetanus shot?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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January 25, 2013
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A:

You should seek medical attention immediately if you are concerned about your injury. This is especially true if a nail or other object broke through your skin and you are not sure when you had your last tetanus booster.

How long it takes for symptoms of tetanus to develop varies widely. You can get symptoms as soon as one day after your injury. Or as late as several months afterwards.

You won’t need a tetanus booster if you completed the primary tetanus series (usually done in childhood) and you are sure you have had a tetanus shot within the past five years.

If it may have been more than five years since you had a tetanus booster, you will need one at the time of injury.

What if it’s not clear that you ever had the primary tetanus series? Then you will be given tetanus immune globulin. This is a preparation of antibodies, or immune-fighting proteins, that are directed against the tetanus. You will also be given the tetanus shot. On top of that, you will then be scheduled for future shots to complete the primary tetanus vaccine series.

Tetanus is caused by the bacteria Clostridium tetani. If the bacteria gain access to human tissues through a puncture wound or other injury, a toxin is released. This toxin travels along the nerves to the spinal cord and brain stem.

Then, a complicated series of events happen. Your muscles become very rigid, with painful spasms in the face, neck, back, abdomen, arms and legs. These spasms last for several weeks. Tetanus is also called “lockjaw” due to the severe spasms of the facial and jaw muscles that commonly develop. Most patients also get fever, blood pressure that swings between too high and too low, fast heart rate (tachycardia), cardiac rhythm disturbances and sweating.

Doctors treat tetanus with antibiotics, tetanus immune globulin, anti-toxin, and muscle relaxers. People with tetanus may not be able to eat or drink for a prolonged period of time. So they’d need IV fluids and tube feedings for hydration and nutrition.

The disease is very rare among Americans. That’s due to near-universal vaccination of all children in the United States. Only about 30 cases per year are reported in the U.S. In contrast, about 1 million cases happen each year in the developing world, killing up to 500,000 people a year.

To prevent tetanus, doctors recommend a repeat tetanus booster once every 10 years for life.

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