Every time I get a patient in for a tetanus booster shot, I always ask “Why are you getting this vaccine today?” Most of the time the answer is either that they haven’t had one in 10+ years or either they or someone close to them is having a baby. Occasionally, someone will say that they stepped on a piece of glass or nail and need the shot to prevent getting tetanus.
What is Tetanus, Diphtheria, & Pertussis:
Tetanus, also known as lockjaw, comes from spores that release tetanus toxin. The tetanus spores can be found in soil and animal feces. It causes involuntary spasms of muscles, most commonly jaw muscles. Left untreated, tetanus can be fatal.[1]
Diphtheria can affect the tonsils/throat or skin, depending on where the infection is located. A white or grey lesion can be seen in the throat whereas a skin infection can look like eczema or psoriasis. Left untreated, the disease can affect the heart or kidneys.[2]
Pertussis, also known as whooping cough, is a respiratory infection that progresses to an increase in coughing that can be followed by whooping inhalation. The disease lasts for 7 weeks, on average, and mostly affects infants and children. The intense, violent coughing can lead to all sorts of complications, including pneumonia, which can be fatal.[3]
If you have made an appointment for a tetanus booster, you will have seen that there are a couple of different options for this vaccine. Which vaccine is right for you?
DTaP[4]: Diphtheria, Tetanus, & Pertussis. This vaccine is given to children under 7 years old in 5 doses: 2, 4, & 6 months old, 15-18 months for dose 4, and 4-6 years old for dose 5.
Td[5]: Tetanus & Diphtheria. This vaccine is for children over 7 years old, adolescents, and adults. It is recommended to get a booster every 10 years to maintain immunity.
Tdap[6]: Tetanus, Diphtheria, & acellular Pertussis. This vaccine is for children over 7 years old, adolescents, and adults. It is given as a single dose in replace of a Td dose. In pregnant women, it is given in the third trimester of every pregnancy to pass the protection to the baby. Tdap can be given every 10 years in place of Td, based on availability, although subsequent doses of Tdap have not been proven to provide increased protection against pertussis.
What if you believe you have come in contact with tetanus toxin from a wound? Certain wounds are at a higher risk of developing into tetanus disease. Clean, minor wounds have the least risk, while dirty or puncture wounds are at a higher risk. In either case, a vaccine will not treat or prevent tetanus disease immediately after receiving the wound. This is the reason why I will ask my patients who come in for a vaccine. I have turned away many patients who are looking for treatment rather than a preventative.
Depending on the vaccination status of the patient and type of wound, tetanus immunoglobulin (TIG)[7] can be given. TIG is the immediate preventative drug for those who have possibly come in contact with tetanus toxins. It needs to be given as soon as possible, any delay can cause the onset of symptoms. TIG is given in hospitals or emergency rooms, not at pharmacies. After being given a TIG dose, patients are recommended to receive a booster or either Td or Tdap, as TIG immunity does not last long. If it has been at least 5 years from the last vaccine, do get a booster to ensure immunity going forward.
Of course, if there is any question, it is safer to be evaluated by a physician to determine the best course of action.
Click here for more information from the CDC website regarding these vaccines.
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