Death from a small scratch. It sounds scary, but this is the reality of past centuries, when the tetanus vaccine had not yet been invented. And the disease still threatens people who have not been vaccinated.
Pediatrician, head of the pediatric department of the clinic “Be Healthy on Sushchevsky Val” Mogilevets Anastasia Nikolaevna explained to Mail.ru Health how modern vaccines protect us from the serious consequences of encountering tetanus.
Tetanus rods can be found everywhere, but most of them are in the soil. Once in the wound, they begin to produce a toxin that affects the nervous system. There is no cure for this disease, only a tetanus shot can prevent the disease.
Who can get tetanus, at what point should you get vaccinated, how is vaccination tolerated and where can you get it – we’ll talk about all this in our article.
In English-speaking countries, tetanus is often called “lockjaw.” Indeed, trismus, that is, spasm and involuntary contraction of the masticatory muscles, is one of the main symptoms of this disease (1).
Tetanus is serious and often fatal. This is a serious disease of the nervous system, which is caused by the tetanus bacillus (clostridium tetani).
Tetanus bacteria live in the soil, in animal feces, but there they seem to be in a dormant state. And when it gets into a wound, the wand “activates” and begins to produce toxins – tetanospasmin and tetanolysin, which affect the human nervous system.
The patient loses control of the muscles; they begin to contract involuntarily, especially the muscles of the neck and jaw. These specific tonic convulsions are often used to make the correct diagnosis.
You can get sick from any scratch, cut, burn, frostbite or bite. There are actually three conditions:
- soil, rust, ash or feces containing tetanus bacilli should enter the wound;
- the bacteria begins to multiply quickly without access to oxygen (this is why deep wounds are especially dangerous when a person, for example, steps on a rusty nail);
- the patient does not have immunity to tetanus (that is, he has not been vaccinated).
The disease can be fatal, especially if its manifestation is missed and you do not immediately go to the hospital. In this case, doctors provide only symptomatic treatment, but it is necessary to prevent the development of life-threatening complications.
What you need to know about tetanus
Most often, tetanus develops in a generalized manner, that is, it spreads throughout the body. The disease usually begins with nagging pain in the wound area, it becomes difficult for a person to open his mouth due to spasm and muscle tone, and a characteristic “sardonic smile” appears.
Then strong and painful convulsions begin: the person arches, while his hands with clenched fists are pulled towards the body.
Spasms occur involuntarily; they can be provoked by sounds, touches and other mild influences on a person.
In addition to the generalized form, localized tetanus (spasms near the wound) and cephalic tetanus (jaw spasms with head wounds) also occur. All local forms of tetanus can develop to a generalized form.
With appropriate treatment, severe symptoms usually go away within two weeks or a little more. Complications may develop, and death occurs in approximately 50% of cases (2).
| Main symptoms |
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| Complications |
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| How it spreads | By contact: Tetanus bacteria enter the body through various wounds. The disease is not transmitted from person to person. |
| Who is sick | All people, regardless of age or gender, who have not received a full tetanus vaccination. |
| At-risk groups |
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| Risk factors |
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Diagnosis of tetanus
Symptoms of the disease do not appear immediately; several days may pass after infection. The average incubation period of the disease is 10 days, but it can be either shorter (only 3 days) or longer (even 21 days).
A person may forget about the wound and cannot correlate the strange symptoms with a small cut that happened, for example, a week ago.
According to the WHO, tetanus is diagnosed based on clinical signs and laboratory confirmation is not required (3).
The disease is diagnosed:
- According to specific symptoms: spasm of the facial muscles, when it seems that the person is smiling, or painful muscle contractions.
- Based on the presence of a wound or injury (including burns, frostbite).
When should you get a tetanus shot?
In our country, the disease is quite rare, because tetanus vaccination is included in the National Preventive Vaccination Calendar. But tetanus is still a threat for people who have not been vaccinated or have not been fully vaccinated.
As planned
You can protect yourself from tetanus with a vaccine that contains tetanus toxoid. This may be a combination vaccine or a single vaccine.
According to the National Calendar, it is recommended that any person receive 6 vaccinations (3 primary and 3 revaccinations) and then additional revaccinations every 10 years (4).
Tetanus vaccination schedule
| 3 months | First vaccination |
| 4.5 months | Second vaccination |
| 6 months | Third vaccination |
| 18 months | First revaccination |
| 6-7 years | Second revaccination |
| 14 years | Third revaccination |
| From 18 years old | Revaccination every 10 years |
In addition, an additional tetanus shot is recommended for travelers if they are traveling to a country or area where there are problems with first aid or vaccines.
Urgently
Emergency tetanus vaccination is given according to indications simultaneously with wound treatment. Vaccination required:
- if a person has suffered an injury/wound to the skin or mucous membranes;
- if a person is bitten by a wild or domestic animal;
- if a person has suffered frostbite or burns;
- after home birth ;
- before surgical interventions.
Emergency vaccination is given no later than the 20th day from the moment of injury/wound.
It is important that after suffering from tetanus, immunity is not developed, re-infection is possible, therefore vaccination in this case is also mandatory (5).
Who should not get the tetanus vaccine?
Tetanus is a life-threatening disease, and all children should be vaccinated against it from an early age. But in some cases, routine tetanus vaccination is still not given:
- If there was a serious local or general reaction to the previous dose of the vaccine (the decision on further vaccination, the possibility of replacing the vaccine, and so on, is made together with the doctor);
- If there are severe allergic reactions to the components included in this vaccine;
- If a person currently has acute (including ARVI) diseases or chronic diseases in the acute stage, vaccination is postponed until remission is achieved.
- During pregnancy and breastfeeding – only as prescribed by a doctor.
Where is the tetanus shot given?
Vaccination takes place against the background of complete health of the child or adult and always after examination by a pediatrician/therapist.
The injection site is treated with an antiseptic, the vaccine is given to small children in the thigh muscle, older children and adults – to the shoulder (also intramuscularly).
Where can I get a tetanus shot?
You can easily get a tetanus vaccination free of charge, under the compulsory medical insurance policy, or for a fee, in a medical institution convenient for you.
1. You can undergo routine vaccination:
- In a clinic or hospital at the place of attachment, treatment or residence. Free vaccination under the compulsory medical insurance policy – for both children and adults.
- In a commercial medical center. Paid or under the VHI policy, if vaccination is included in it.
2. Emergency vaccination can be done:
- In the nearest emergency room, clinic, hospital free of charge under the compulsory medical insurance policy.
- At the nearest commercial medical center that is most convenient for you to get to.
Side effects after tetanus vaccination
The vaccination is usually well tolerated, with minor local reactions being the most common side effects.
Normal reaction:
- slight pain at the injection site;
- swelling and redness at the injection site;
- slight increase in temperature;
- stool disorder;
- loss of appetite.
Dangerous symptoms:
- severe allergic reactions after vaccination, including angioedema;
- rise in temperature and swelling at the injection site for longer than 2-3 days.
In these cases, you should consult a doctor, preferably at the same institution where you were vaccinated.
What you can and cannot do before and after a tetanus shot
There are no special recommendations here; the requirements are standard, as with any other vaccination.
What is not recommended to do during vaccination:
- After the injection, avoid heavy physical activity for several days, and give up sports if it is associated with it.
- Do not drink alcohol for 3 days before and after vaccination.
Oddly enough, the graft can be wetted, but there is no need to rub it with a washcloth. You can also take a bath or shower without any problems, but you do not need to visit the bathhouse or sauna immediately after vaccination, wait a couple of days.
What tetanus vaccines exist and what are they called?
Typically, young children receive combined vaccinations, often imported vaccines, which are believed to be better tolerated.
The choice of vaccine depends on the person’s age, whether vaccination is carried out or revaccination, and other circumstances.
- Combined vaccine “Pentaxim” (France). From diphtheria, tetanus, hemophilus influenzae, polio, whooping cough.
- Combined vaccine “Infanrix hexa” (Belgium). From diphtheria, tetanus, whooping cough, polio, hepatitis B, Haemophilus influenzae type b.
- Combined vaccine “Infanrix” (Belgium). From diphtheria, whooping cough and tetanus.
- Combined vaccine DTP (Russia). From diphtheria, whooping cough and tetanus.
- Combined vaccine “Bubo-Kok”. From hepatitis B, whooping cough, tetanus and diphtheria.
- Monovaccine AS (Russia) – tetanus toxoid.
- ADS-M (Russia) – with a reduced content of diphtheria and tetanus antigens.
- Combined vaccine “ADASEL” (Canada). From diphtheria, tetanus, whooping cough. Typically used for revaccination.
Doctor’s review of tetanus vaccination
The vaccine includes tetanus toxoid – these are chemically inactivated (neutralized) toxins of the tetanus bacillus, which are not capable of causing intoxication, but are capable of forming an immune response. When the body receives a vaccine that contains toxoid, the immune system learns to fight against natural toxins.
Tetanus toxoid is capable of forming immunity in almost 100% of those vaccinated. Tetanus vaccines, upon completion of the primary course of vaccinations, provide immunity lasting about 10 years. This explains the need for revaccination.
What is important to remember about the tetanus shot?
| When it’s done | Planned and emergency (after injury or wound). |
| Who should not get routine vaccinations? | If you have allergies, fever or exacerbations of a chronic disease. |
| Where is it placed? | Usually – in the shoulder, for babies – in the thigh. |
| Where can I do it? | In any clinic, hospital or emergency room. |
| Side effects | Most often local, possible temperature. |
| What are the prohibitions? | After vaccination, you need physical rest, without heavy exertion. Bathhouse and sauna are limited. |
| What vaccines | Most often they are combined, but you can also make a single vaccine, only for tetanus. |
| The most popular vaccines | “Pentaxim”, “Infanrix hexa”, “Infanrix”, DPT and monovaccine against tetanus. |