When it comes to tetanus vaccination, it’s not one and done.

You receive the vaccine in a series. It’s sometimes combined with vaccines that protect against other diseases, such as diphtheria. A booster shot is recommended every 10 years.

In children

The DTaP vaccine is one immunization that protects against three diseases: diphtheria, tetanus, and pertussis (whooping cough). The American Academy of Pediatrics (AAP) recommends children receive the DTaP vaccine at the following intervals:

  • 2 months
  • 4 months
  • 6 months
  • 15 to 18 months
  • 4 to 6 years

The DTaP vaccine isn’t given to children older than age 7.

Children should receive the Tdap booster shot at about age 11 or 12. Tdap is similar to DTaP since it protects against the same three diseases.

Ten years after receiving the Tdap, your child will be an adult and should receive the Td shot. The Td shot provides protection against tetanus and diphtheria.

In adults

Adults who were never vaccinated or who didn’t follow the complete set of vaccinations as a child should receive a Tdap shot followed by two doses of Td at varying intervals.

According to the Immunization Action Coalition, the first Td shot is given 1 to 2 months after the first Tdap shot. The third dose of Td is received 6 to 12 months later, followed by another Td shot every 10 years.

In pregnant women

The Tdap vaccination is recommended for all pregnant women. This shot gives your unborn baby a head start on protection against pertussis (whooping cough). If you didn’t get the Td or Tdap shot in the last 10 years, the shot may provide your unborn baby with protection from tetanus, which can cause fetal death. It also reduces your risk of diphtheria. These conditions can be deadly to newborns.

The Tdap vaccine is safe during pregnancy. For optimal immunity, the Centers for Disease Control and Prevention generally recommend receiving the shot between 27 and 36 weeks, but it’s safe to receive at any point in your pregnancy.

If you don’t know if you’ve been vaccinated, you may need a series of shots.

The tetanus vaccine doesn’t provide lifelong immunity. Protection begins to decrease after about 10 years, which is why doctors advise booster shots every decade.

Your doctor may recommend children and adults get a booster shot after only five years if there’s a suspicion you may have been exposed to tetanus-causing spores. For example, if you step on a rusty nail or have a deep cut that’s been exposed to infected soil, your doctor may recommend a booster.

Tetanus is rare in the United States. An average of only 30 cases are reported each year. Nearly all cases involve people who have never received a tetanus shot or who don’t stay current with their boosters. Vaccination is essential to prevent tetanus.

Complications from tetanus vaccinations are extremely rare, and the disease itself poses far more risks than the vaccine. When side effects do occur, they’re generally mild and include:

  • fever
  • fussiness in babies
  • swelling at the injection site

Serious problems are extremely rare, but can include:

  • allergic reaction
  • seizures
  • brain damage

If you think you or your child may be having an allergic reaction to the vaccine, seek immediate medical help. Signs of an allergic reaction may include:

  • hives
  • difficulty breathing
  • fast heartbeat

Some people shouldn’t be vaccinated, including people who:

Tetanus is a serious disease caused by bacteria called Clostridium tetani. The spores of the bacteria live in soil, dust, saliva, and manure. If an open cut or wound is exposed to the spores, they can enter your body.

Once inside the body, the spores produce toxic bacteria that affects muscles and nerves. Tetanus is sometimes called lockjaw because of the stiffness it can cause in the neck and jaw.

The most common scenario for catching tetanus is stepping on a dirty nail or sharp shard of glass or wood that pierces through the skin. Puncture wounds are most prone to tetanus because they’re narrow and deep. Oxygen can help kill the spores of the bacteria, but unlike gaping cuts, puncture wounds don’t allow oxygen much access.

Other ways you may develop tetanus:

  • contaminated needles
  • wounds with dead tissue, such as burns or frostbite
  • a wound that’s not cleaned thoroughly

You can’t catch tetanus from someone who has it. It’s not spread from person to person.

The time between exposure to tetanus and the appearance of symptoms ranges between a few days to a few months. Most people infected with tetanus will experience symptoms within 14 days of exposure.

Symptoms you may experience include:

  • headache
  • stiffness in your jaw, neck, and shoulders, which can gradually extend to other parts of the body, causing muscle spasms
  • trouble swallowing and breathing, which can lead to pneumonia and aspiration
  • seizures

Tetanus can be fatal. The Immunization Action Coalition states about 10 percent of reported cases have led to death.

There’s no cure for tetanus. You can manage symptoms by using sedatives to control muscle spasms. Most treatment consists of trying to reduce exposure to the toxins produced by the bacteria. To do that, your doctor may advise:

  • thorough wound cleaning
  • a shot of tetanus immune globulin as an antitoxin, but only if the toxins haven’t adhered to nerve cells
  • antibiotics
  • tetanus vaccine

Tetanus is a potentially deadly disease, but it can be prevented by staying up-to-date on your vaccine schedule and getting boosters every 10 years. If you suspect you may have been exposed to tetanus, see your doctor. In some cases, they may recommend a booster following the injury.