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Tetanus Vaccine and Disease Information

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Tetanus: The Disease

Tetanus (lockjaw) disease is caused by Clostridium tetani (C. tetani), an anerobic, gram-positive, bacteria with the ability to develop into a spore. Tetanus spores can be found in soil, manure, and in the digestive tracts of animals and humans. Additionally, tetanus has also been reportedly found in contaminated heroin and on skin surfaces.1  Tetanus bacteria do not survive in the presence of oxygen, however, are quite resistant to most chemicals and even heat.2 Puncture wounds, which do not bleed very much and are protected by tissue and skin from direct exposure to oxygen, can be the perfect environment for tetanus bacteria to multiply and cause infection.3

The incubation period for tetanus infection, from time of exposure to appearance of the first symptoms, ranges from three days to three weeks.4 Initial symptoms include muscular stiffness of the jaw and neck, headache, seizures, changes in heart rate and blood pressure, fever, and chills. Complications include fractures, vocal cord spasms, impaired breathing, pulmonary embolism, pneumonia, infections acquired in the hospital during the course of treatment, and death.5 Learn more about Tetanus

Tetanus Vaccine

In the U.S. today, tetanus vaccine is administered only in a combination shot (DTaP, DT, Tdap, Td) that contains vaccines for tetanus (T), diphtheria (D) and possibly pertussis (whooping cough) (P). The U.S. Food and Drug Administration has approved twelve different combination vaccines that include tetanus toxoid vaccine. There are different rules for use of these vaccines by different aged groups. The CDC’s Advisory Committee on Immunization Practices (ACIP) currently recommends administration of a tetanus containing vaccine (DTaP) at two, four, and six months old; between 15 and 18 months old; and between four and six years old. Another booster dose is recommended at 11-12 years of age (Tdap).

After a booster dose of Tdap vaccine, booster doses with tetanus - diphtheria toxoid vaccine (Td) are recommended every ten years throughout a person’s life.6  While the ACIP also recommends that pregnant women receive a dose of Tdap vaccine during each pregnancy, between 27 and 36 weeks gestation, regardless of a previous history of Tdap vaccine,7 this recommendation contradicts the information provided by the vaccine manufacturers. Learn more about Tetanus vaccine

Tetanus Quick Facts

Tetanus

  • Tetanus, often referred to as lockjaw, is caused by the Clostridium tetani bacteria and can be found in soil, manure, and even in the digestive tracts of animals and humans. Tetanus has also been reported in contaminated heroin as well as on skin surfaces.8 Tetanus is not contagious and cannot be transmitted from person to person.9 Tetanus bacteria can enter the body when a person sustains a deep cut, or even a burn10 and can also occur following abortions, elective surgeries, ear infections, pregnancy, dental infections, animal bites, and crush wounds.11
  • The incubation period for tetanus infection, from time of exposure to appearance of the first symptoms, ranges from three days to three weeks.12 Initial symptoms include muscular stiffness of the jaw and neck, headache, seizures, changes in heart rate and blood pressure, fever, and chills. Complications include fractures, vocal cord spasms, impaired breathing, pulmonary embolism, pneumonia, infections acquired in the hospital during the course of treatment, and death.13 Continue reading quick facts

Tetanus Vaccine

  • There are 12 different tetanus-containing vaccines licensed for use in the United States with 8 tetanus combination vaccines available for use in infants and children. These combination vaccines may contain one or more of the following vaccines: pertussis, diphtheria, hepatitis B, Hib, polio, and/ or polio. For adults, there are 4 tetanus combination vaccines available with 2 vaccines containing both tetanus and diphtheria toxoids approved for use in adults and children ages 7 years and older and 2 vaccines containing tetanus and diphtheria toxoid and acellular pertussis approved for use in children and adults ages 10 years and older.14
  • According to the CDC, common tetanus vaccine reactions include injection-site redness, pain, and swelling at the site of the injection. Sometimes, however, the pain and swelling is significant and extends from the shoulder to the elbow. If this occurs, the CDC warns that additional tetanus toxoid vaccine doses should not be administered more frequently than every 10 years.15 Additional serious reported side effects following tetanus toxoid vaccination include anaphylaxis,16 17 brachial neuritis,18 Guillain-Barre Syndrome,19 20 acute disseminated encephalomyelitis (ADEM),21 arthritis22 23and myocarditis.24 Continue reading quick facts

Tetanus Disease & Vaccine Information

Find the Information You Need to Make an Informed Vaccine Decision

Tetanus: The Disease

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References

1 CDC Tetanus - Clostridium tetani Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

2 Ibid

3 CDC Tetanus – Pathogenesis Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

4 CDC Tetanus - Clinical Features Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

5 CDC Symptoms and Complications Feb. 28, 2019

6 CDC Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Apr. 27, 2018 / 67(2);1–44

7 Ibid

8 CDC Tetanus - Clostridium tetani Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

9 CDC Tetanus - Epidemiology Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

10 MedlinePlus Tetanus – Summary May 23, 2018

11 CDC Tetanus - Epidemiology Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

12 CDC Tetanus - Clinical Features Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

13 CDC Symptoms and Complications Feb. 28, 2019

14 FDA Vaccines Licensed for Use in the United States Mar. 18, 2019

15 CDC Tetanus – Adverse Reactions Following Vaccination Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

16 Mayorga C, Torres MJ, Corzo JL et al. Immediate allergy to tetanus toxoid vaccine: determination of immunoglobulin E and immunoglobulin G antibodies to allergenic proteins. Ann Allergy Asthma Immunol. 2003 Feb;90(2):238-43.

17 Martín-Muñoz MF, Pereira MJ, Posadas S et al. Anaphylactic reaction to diphtheria-tetanus vaccine in a child: specific IgE/IgG determinations and cross-reactivity studies. Vaccine. 2002 Sep 10;20(27-28):3409-12.

18 Hamati-Haddad A, Fenichel GM. Brachial neuritis following routine childhood immunization for diphtheria, tetanus, and pertussis (DTP): report of two cases and review of the literature. Pediatrics. 1997 Apr;99(4):602-3.

19 Bakshi R, Graves MC. Guillain-Barré syndrome after combined tetanus-diphtheria toxoid vaccination. J Neurol Sci. 1997 Apr 15;147(2):201-2.

20 Newton N Jr, Janati A. Guillain-Barré syndrome after vaccination with purified tetanus toxoid. South Med J. 1987 Aug;80(8):1053-4.

21 Hamidon BB, Raymond AA. Acute disseminated encephalomyelitis (ADEM) presenting with seizures secondary to anti-tetanus toxin vaccination. Med J Malaysia. 2003 Dec;58(5):780-2.

22 Jawad AS, Scott DG Immunisation triggering rheumatoid arthritis? Ann Rheum Dis. 1989 Feb; 48(2): 174.

23 Kaul A, Adler M, Alokaily F, Jawad A Recurrence of reactive arthritis after a booster dose of tetanus toxoid Ann Rheum Dis. 2002 Feb; 61(2): 185.

24 Amsel SG, Hanukoglu A, Fried D, Wolyvovics M Myocarditis after triple immunisation. Arch Dis Child. 1986 Apr; 61(4): 403–405.


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