Vaccines and Preventable Diseases:Tetanus (Lockjaw) Vaccination
- Author: Wednesday, October 20th, 2010
Tetanus leads to death in about 1 in 10 cases. Several vaccines are used to prevent tetanus among children, adolescents, and adults including DTaP, Tdap, DT, and Td.
Tetanus Disease In-Short (Lockjaw):
A disease of the nervous system caused by Clostridium tetani bacteria
Early symptoms: lockjaw, stiffness in the neck and abdomen, and difficulty swallowing
Later symptoms: severe muscle spasms, generalized tonic seizure-like activity, severe autonomic nervous system disorders
Bone fractures, abnormal heart rhythm
Death in about 10-20% of cases, with the highest rates occurring among older people
Enters the body through a break in the skin. Tetanus is not transmitted from person to person.
Tetanus toxoid (contained in Tdap, DT, DTaP, and Td vaccines) can prevent this disease. Tetanus toxoid was also contained in DTP (an older version of DTaP); and DTaP is contained in several other combination vaccines, such as Pediarix, Pentacel, Kinrix, and TriHIBit.
Does my infant need this vaccine?
Yes, the Advisory Committee on Immunization Practices (ACIP) recommends 5 doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine for infants and children. One dose of DTaP vaccine is recommended at each of the following ages: 2 months, 4 months, 6 months, 15-18 months, 4-6 years old. DTaP vaccine may be given at the same time as other vaccines.
As an adult, do I need this vaccine?
Everyone needs protection from tetanus. If you have not had a booster shot in 10 years or more, you should receive a tetanus shot. If you never had the initial childhood tetanus vaccines, you should receive a series of three tetanus shots.
Some children should not get DTaP vaccine or should wait.
Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine. Any child who had a life-threatening allergic reaction after a dose of DTaP should not get another dose. Any child who suffered a brain or nervous system disease within 7 days after a dose of DTaP should not get another dose.
Talk with your doctor if your child: had a seizure or collapsed after a dose of DTaP cried non-stop for 3 hours or more after a dose of DTaP had a fever over 105 degrees Fahrenheit after a dose of DTaP.
Pregnant women should receive Td vaccine if indicated. Previously vaccinated pregnant women who have not received a Td vaccination within the last 10 years should receive a booster dose. 1 Pregnant women who have not received three doses of a vaccine containing tetanus and diphtheria toxoids should complete a series of 3 vaccinations. Two doses of Td should be administered during pregnancy to ensure protection against maternal and neonatal tetanus. The preferred schedule in pregnant women is two doses of Td separated by 4 weeks, and a dose of Tdap 6 months after the second dose (post-partum). Healthcare providers can choose to substitute a single dose of Tdap for a dose of Td during pregnancy. 11 Although no evidence exists that tetanus and diphtheria toxoids are teratogenic, waiting until the second trimester of pregnancy to administer Td is a reasonable precaution for minimizing any concern about the theoretical possibility of such reactions. 12
Tetanus, Diphtheria and Pertussis (Tdap):
Pregnancy is not a contraindication for use of Tdap. Data on safety, immunogenicity and the outcomes of pregnancy are not available for pregnant women who receive Tdap.When Tdap is administered during pregnancy, transplacental maternal antibodies might protect the infant against pertussis in early life. They also could interfere with the infant's immune response to infant doses of DTaP, and leave the infant less well protected against pertussis. 11 ACIP recommends Td when tetanus and diphtheria protection is required during pregnancy. In some situations,healthcare providers can choose to administer Tdap instead of Td to add protection against pertussis. When Td or Tdap is administered during pregnancy, the second or third trimester is preferred