Vaccination is the best way to prevent a tetanus infection. A complete course of tetanus vaccination consists of five doses.
The vaccine allows your body to create antibodies against the tetanus toxin (tetanospasmin). This protects you from the illness if you are exposed to the Clostridium tetani bacterium in the future.
In the UK, all children are routinely offered the tetanus vaccine as part of the NHS childhood vaccination programme.
If you are not sure whether you have been fully vaccinated against tetanus, speak to your GP or practice nurse. They will be able to advise you about having a booster injection.
Primary vaccination
The primary course of the tetanus vaccination consists of three doses of the vaccine. The doses are given one month apart.
The DTaP/IPV/Hib vaccine
The tetanus vaccine forms part of the combined DTaP/IPV/Hib vaccination. This provides protection against:
- diphtheria (D) – an infection that can cause breathing difficulties
- tetanus (T)
- pertussis (whooping cough) (aP) – a type of infection that can cause prolonged and severe bouts of coughing
- polio (IPV or inactivated polio vaccine) – an infection that usually causes mild flu-like symptoms, but can occasionally cause more serious symptoms such as loss of normal muscle function
- Hib (haemophilus influenzae type b) – a bacterial infection that can cause a number of serious illnesses such as pneumonia, blood poisoning and meningitis
It is recommended that the DTaP/IPV/Hib vaccination is given to babies at two, three and four months of age. However, it can be given at any stage between two months and 10 years of age.
If the primary course is interrupted, it should be resumed (but not repeated) with an interval of one month between the remaining doses.
Babies who are born prematurely should be vaccinated at the appropriate age according to the vaccination schedule. There is no evidence that premature babies are at increased risk of having adverse reactions to vaccines.
See the vaccination checklist for more information and advice.
Most children can have the DTaP/IPV/Hib vaccine. However, it should not be given to children who:
- have had a severe allergic reaction (anaphylaxis) to a previous dose
- have had an anaphylactic reaction to any component of the vaccine (including neomycin, streptomycin and polymyxin B, which may be present in small amounts)
If your child is unwell and has a high temperature, postpone their DTaP/IPV/Hib vaccine until they have recovered. It is fine for your child to have the vaccine if they have a minor illness, such as a cold or cough.
Side effects
Within 12 to 24 hours of having the DTaP/IPV/Hib vaccine, your child may experience some mild side effects, including:
- swelling and redness at the site of the injection
- a small lump at the site of the injection, which may last for a few weeks
- a slightly raised temperature
- some sickness or diarrhoea
- your child may be irritable and miserable
In very rare cases (less than 1 in 1,000), babies can have more serious side effects around 24 to 48 hours after receiving the DTaP/IPV/Hib vaccine, including:
- a very high temperature
- febrile convulsions (a seizure associated with a fever)
- an unusually high-pitched cry
- being floppy and less responsive than usual
Contact your GP immediately if your baby has a fit. They may have an illness that is unrelated to the vaccine. Whatever the cause, it is important to tell your GP. Babies usually fully recover after having a fit.
Do not delay having your baby vaccinated as doing so can increase their risk of having fits. It is very important to ensure that your child is vaccinated at the right age.
As with all vaccines, there is a rare possibility that the DTaP/IPV/Hib vaccine will cause anaphylaxis (a severe allergic reaction). However, the risk is less than one in a million.
The potential risk of vaccination is far outweighed by the benefits of being protected against serious diseases, such as tetanus.
Speak to your GP or call NHS Direct on 0845 46 47 if you think your child has had a reaction to the DTaP/IPV/Hib vaccine.
Read more about the DTaP/IPV/Hib vaccine.
Secondary immunisation
The first booster dose
Children under the age of 10 should be given the first tetanus booster combined with the diphtheria, pertussis and polio vaccines (DTaP/IPV or dTaP/IPV). Ideally, the first tetanus booster should be given three years after the primary course is completed. This is usually when a child is three-and-a-half to five years of age.
If the primary vaccination was delayed, the first booster dose can be given at the scheduled time, as long as the third primary dose was given at least one year before. This allows the child to get back on to the routine schedule.
The DTaP/IPV vaccine should be used for children under the age of 10.
Children over 10 who have had three doses of the primary vaccination, with the last dose received at least five years ago, should be given the first tetanus booster combined with the diphtheria and polio vaccines (Td/IPV).
The second booster dose
Ideally, the second booster dose (Td/IPV) should be given 10 years after the first booster dose. However, if previous doses were delayed, the second booster dose can be given at the scheduled time, as long as at least five years have passed since the first booster dose was given. This is the last scheduled opportunity to ensure long-term protection.
See the vaccination checklist for when vaccines should be given.
The Td/IPV vaccine
Td/IPV is recommended for children who are 13–18 years old. Td/IPV is a booster vaccine that tops up protection against three different illnesses:
- tetanus (T)
- diphtheria (d)
- polio (IPV or inactivated polio vaccine)
After having a Td/IPV vaccine, your child may experience some swelling and redness at the site of the injection. A small, painless lump may also develop, although it will usually disappear after a few weeks.
More serious side effects are less common, but may include:
- a high temperature (fever) of 38C (100.4F) or above
- headaches
- dizziness
- nausea and vomiting
- swollen glands
