Tetanus, also called lockjaw, is a serious but rare condition. Around 20% of people who get this disease die. Tetanus shots are very effective in preventing deaths from tetanus. Thanks to the tetanus vaccine, this disease is uncommon in the US, and only around 30 cases occur each year.

However, to protect yourself, you need to be up-to-date on your tetanus shots, including booster shots every 10 years or sooner (5 years) if you suffer an injury.

Please continue reading to learn more about tetanus, why tetanus deaths occur, how to prevent tetanus, and whether you need a tetanus shot for a small puncture wound.

What is tetanus infection?

Tetanus is a serious bacterial infection caused by a microorganism called Clostridium tetani found in dirt, soil, and feces. The bacteria enter the body through cuts, wounds, punctures, crush injuries, burns, or animal bites — anywhere that the skin is broken and exposed to soil or dirt.

Once inside the body, the tetanus bacteria make toxins. The toxin’s effect interferes with the nervous system, causing muscle contractions and spasms. In severe tetanus, the muscle spasms can be strong enough to cause fractures. The term “lockjaw” comes from the painful tightening of the jaw muscles, making it difficult to open the mouth, breathe, and swallow. In very severe tetanus, the toxins can lead to paralysis (inability to move) and respiratory failure due to paralysis of the respiratory muscles.

Thanks to the tetanus vaccine, the disease is now rare in the United States. However, tetanus is a serious and potentially fatal infection when it does occur.

Tetanus patients are not contagious, meaning the infection doesn’t spread from person to person. There is no cure for tetanus. Getting a tetanus jab is the best way to protect yourself from this dangerous infection. Most tetanus deaths occur in unvaccinated individuals.

Can you get tetanus from a small puncture?

Yes, any skin injury with a break in the skin, including a small skin puncture, puts you at risk of a tetanus infection. The bacteria that cause tetanus can enter your body through any wound in the skin, including minor cuts and scrapes, especially those that have obvious dirt or were exposed to soil.

Do I need a tetanus shot for a small nail puncture?

Yes, as mentioned above, the wound size doesn't matter — you can get tetanus and other bacterial infections from minor wounds. Puncture wounds from objects such as nails, or animal bites (such as a dog bite) put you at the greatest risk of a tetanus infection.

If you have a puncture wound from a nail, you should clean the skin wound with soap and water to prevent infection. It may be possible to treat a minor injury at home. However, please see your healthcare provider if the wound becomes more painful and red or you have other concerns.

If your last tetanus shot was more than 10 years ago, you should get in touch with your doctor and receive proper treatment, which may include getting a booster shot of the Td or Tdap vaccine.

How soon after a cut should you get a tetanus shot?

Many people wonder — how quickly does tetanus set in? The incubation period of tetanus (time between exposure and illness) ranges from 3 to 21 days and averages 10 days.

But it’s important to act fast. If you have an injury and think you might be at risk of tetanus, and if you haven’t had a tetanus booster shot within the past 5 years, go to the emergency room within 24 hours.

What happens if you don't get a tetanus shot after a cut?

Mild tetanus usually starts with muscle spasms, typically in the jaw muscles. In moderate tetanus, there can be spasms affecting the neck, chest, back, and abdomen muscles. In severe tetanus, the spasms can affect the respiratory muscles needed for breathing, leading to trouble breathing and potentially even death.

Other symptoms of tetanus can include fever, sweating, headache, muscle stiffness, convulsions, fast heart rate, and high blood pressure. These are signs and symptoms caused by the body’s immune response to fight off the infection.

Tetanus infection requires emergency medical care. If you notice any of the above symptoms in an injured person, call 911 or take them to the nearest emergency without delay.

CDC recommendations for tetanus vaccinations

The Centers for Disease Control and Prevention (CDC) recommends tetanus vaccines for everyone. There are four types of vaccines available to prevent tetanus. These vaccines also protect against other bacterial infections, namely diphtheria, and pertussis.

Diphtheria and tetanus (DT) vaccine
Diphtheria, tetanus, and pertussis (DTaP) vaccine
Tetanus and diphtheria (Td) vaccine
Tetanus, diphtheria, and pertussis (Tdap) vaccine

DTaP and DT vaccines are given to babies and children under 7. Tdap and Td vaccines are given to older children and adults. The recommended tetanus set in children is 5 doses of DTaP at ages 2 months, 4 months, 6 months, 15-18 months, and 4-6 years, followed by a booster shot (6th dose) of Tdap at 11-12 years.

After the initial tetanus series during childhood, you need a tetanus booster shot every 10 years or sooner (5 years) if you suffer an injury.

If your last tetanus shot was more than 10 years ago, talk to your doctor about getting one. A tetanus shot is not something you need only after stepping on a rusty nail. To prevent this potentially deadly disease, all adults need to get a tetanus booster every 10 years.

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