Tetanus Immunisation

All children and adults should be immunised against tetanus. See your practice nurse if you think that you are not fully immunised.

What is tetanus?

Tetanus is a serious infection which affects the nerves, and is often fatal. Tetanus bacteria (germs) live in the soil and dirt. The bacteria may get into your body through a cut or a wound in the skin. The bacteria make a toxin (poison) which causes the illness. Even small wounds such as a prick from a thorn can allow enough bacteria to get into the body to cause tetanus. The illness takes up to 21 days to develop, so a small cut is often forgotten about before the illness starts.

The vaccine

The vaccine stimulates your body to make antibodies against the tetanus toxin. These antibodies protect you from illness should you become infected with this bacteria.

Tetanus immunisation timetable

A full course of tetanus immunisation consists of five doses of vaccine as follows:

  Children Adults
(who have not been immunised as a child)
Primary Course Three doses of vaccine (usually as DTP-Hib) at two, three and four months of age Three doses of vaccine (as Td) each one month apart
4th dose Three years after the primary course - as part of the DTP 'pre-school booster' 10 years after the primary course (as Td)
5th dose Aged 13-18 years - the 'school leaver booster' (as Td) 10 years after 4th dose (as Td)

The primary course of three injections gives good protection for a number of years. The fourth and fifth doses ('boosters') are needed in later years to maintain protection. After the fifth dose, immunity remains for life and you do not need any further injections.

All children are offered tetanus immunisation as part of the routine immunisation programme.

However, some adults have not been fully immunised against tetanus as routine immunisation for children was not introduced until 1961. Men serving in the armed forces from 1938 onwards were offered tetanus immunisation. So, some older people may still be at risk.

See a practice nurse if you think that you are not fully immunised against tetanus (that is - if you have not had five injections in total). The course does not need to be started again if an injection is delayed. A late injection is sufficient to 'catch up', even if you have it years after it was due.

Do I need a dose of tetanus vaccine after cuts, bites, etc?

I am going abroad - do I need a tetanus immunisation?

Usually not if you are up-to-date with your immunisations.

However, if:

a dose of vaccine may be advised. This is a precautionary measure in case you have a very dirty wound and do not receive antiserum.

Are there any side-effects from tetanus immunisation?

It is common to get a little redness and swelling around the injection site which goes after a few days. Occasionally, some people feel slightly unwell for a day or so with a mild headache, slight aching of the muscles, and a mild fever. Some people get reactions to the injection if they have more than the recommended number, or have a dose of vaccine too early. Severe reactions are rare.

Who should not receive tetanus immunisation?

If you are unwell with an illness causing a fever, it is wise to postpone an injection until the illness has gone (except if the dose is needed after a cut or wound). Also, you should not have another injection of vaccine if a previous injection caused a severe reaction.

Further information

Information on immunisation from the NHS aimed at the general public - www.immunisation.org.uk

Immunisation Against Infectious Disease (The Green Book) - www.doh.gov.uk/greenbook/
From the Department of Health. Aimed at health professionals but of interest to all.

© EMIS and PIP 2004   Updated February 2004   PRODIGY Validated