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Tetanus: Causes, Symptoms, Vaccines and Wound Care Guide

Last updated November 1, 2026

Tetanus is a serious disease caused by the bacterium Clostridium tetani. The bacteria live in the environment and usually enter the body through a cut or wound. Tetanus is a medical emergency that needs immediate treatment in a hospital.

Tetanus does not spread from person to person. It can be prevented with vaccines, and people who recover from tetanus still need to be vaccinated, because the disease does not give natural immunity.

What Causes Tetanus?

Tetanus is caused by spores of C. tetani. The spores are found everywhere in the environment, including:

  • Soil and ash.
  • The intestines and feces of animals and humans.
  • Skin surfaces.
  • Rusty tools, such as nails, needles and barbed wire.

The spores resist heat and most antiseptics, and they can survive for years. The bacterium grows where there is no oxygen, for example in dirty wounds or in an umbilical cord that is not kept clean. It makes a toxin that can cause serious complications or death.

Who Is at Risk?

Anyone can get tetanus. The CDC lists several factors that raise the risk:

  • Never having had a tetanus vaccine, not finishing the first series, or not being up to date with 10-year boosters.
  • A recent wound, especially one that is deep or contaminated with dirt.
  • Being 80 years or older.
  • Having diabetes or a condition that weakens the immune system.
  • Using injection drugs.

Symptoms of Tetanus

Symptoms usually appear between 3 and 21 days after exposure, with an average of 8 days. Most cases occur within 14 days.

The first sign is most often spasms of the jaw muscles, called “lockjaw.” Other symptoms can include:

  • Trouble swallowing.
  • Sudden, painful muscle spasms, often triggered by sudden noises.
  • Painful muscle stiffness all over the body.
  • Seizures.
  • A headache.
  • Fever and sweating.
  • Changes in blood pressure and heart rate.

In newborns, the first signs are often that the baby cannot suck or breastfeed and cries too much. Muscle spasms follow.

Complications

Tetanus can cause serious health problems, such as uncontrolled tightening of the vocal cords, broken bones, a blood clot in the lungs, aspiration pneumonia and difficulty breathing. In the United States, about 1 in 10 cases of tetanus are fatal.

Contact a healthcare provider right away if you have symptoms of tetanus.

Diagnosis and Treatment

Healthcare providers diagnose tetanus by looking at the signs and symptoms. They may ask about recent cuts, scrapes, punctures or other injuries. No laboratory test can confirm tetanus.

Tetanus is a medical emergency. Treatment includes:

  • Care in a hospital.
  • Immediate treatment with a medicine called human tetanus immune globulin (TIG).
  • Aggressive wound care.
  • Drugs to control muscle spasms.
  • Antibiotics.
  • Tetanus vaccination.

Depending on how serious the infection is, a person may need a machine to help them breathe.

Wound Care

Good wound care, given right away, can help prevent infection. The CDC advises people to:

  • Apply first aid to even minor wounds.
  • Wash their hands with soap and water, or use an alcohol-based hand rub.
  • See a healthcare provider if a wound is deep or a puncture, such as from stepping on a nail.
  • See a healthcare provider if a wound contains dirt, soil, feces or saliva, such as an animal bite.
  • See a healthcare provider if a wound contains dead tissue, such as from burns, fractures, crush injuries or frostbite.

After some wounds, a person may need TIG and a tetanus vaccine to prevent infection. Providers can give TIG to a person who has a serious or contaminated wound and is not up to date with tetanus vaccination. Whether a person needs a vaccine dose depends on their vaccination history.

Tetanus Vaccines

All tetanus vaccines are combined with vaccines for other diseases:

  • DT: diphtheria and tetanus.
  • DTaP: diphtheria, tetanus and pertussis (whooping cough), for children younger than 7 years.
  • Td: tetanus and diphtheria, for older children and adults.
  • Tdap: tetanus, diphtheria and pertussis, for older children and adults.

The CDC Schedule

In the United States, the CDC recommends tetanus vaccination for people of all ages:

  • Babies get 3 shots of DTaP, at 2 months, 4 months and 6 months.
  • Children get 2 DTaP booster shots, at 15 to 18 months and at 4 to 6 years.
  • Preteens get 1 shot of Tdap at 11 or 12 years.
  • Adults get a booster every 10 years. After 1 dose of Tdap, adults can get either Td or Tdap.
  • Pregnant women get Tdap early in the third trimester of every pregnancy, mainly to protect newborns from whooping cough.

The vaccines work well, but protection decreases over time. That is why adults need a booster every 10 years.

WHO Recommendations

To be protected throughout life, WHO recommends 6 doses of a tetanus-toxoid-containing vaccine: 3 primary doses and 3 boosters.

  • The 3 primary doses should start as early as 6 weeks of age, with at least 4 weeks between doses.
  • The boosters should be given at 12 to 23 months, at 4 to 7 years and at 9 to 15 years.
  • Ideally, there should be at least 4 years between booster doses.

In 2025, 85% of infants worldwide received 3 doses of a diphtheria-tetanus-pertussis vaccine.

Talk with a vaccine provider about your vaccination history, any allergies and any past reactions to a vaccine. Most side effects are mild, such as soreness at the injection site or a mild fever, and usually go away within a few days. Serious reactions are possible, so tell the provider about any past reaction.

Maternal and Neonatal Tetanus

Most reported tetanus cases are linked to birth. They occur in newborn babies and mothers who have not had enough doses of tetanus vaccine.

  • Maternal tetanus is tetanus during pregnancy or within 6 weeks after the end of pregnancy.
  • Neonatal tetanus is tetanus in the first 28 days of life.

Neonatal tetanus can occur when unsterile instruments are used to cut the umbilical cord, or when contaminated material is used to cover the cord stump. Births handled by people with unclean hands, or on a contaminated surface, also raise the risk.

Prevention

Neonatal tetanus can be prevented by vaccinating women of childbearing age, either during or outside of pregnancy. Clean delivery and clean cord care at birth also prevent the disease.

Progress Toward Elimination

In 1989, the World Health Assembly launched a global goal to eliminate neonatal tetanus as a public health problem. Elimination means fewer than 1 case of neonatal tetanus per 1,000 live births in every district.

In 1999, UNICEF, WHO and the United Nations Population Fund (UNFPA) launched the Maternal and Neonatal Tetanus Elimination (MNTE) Initiative.

The results are large:

  • In 2000, an estimated 46,898 newborn babies died of tetanus in their first month of life.
  • In 2021, just over 7,700 newborns died from neonatal tetanus, a reduction of 84%.
  • WHO links this fall mainly to wider vaccination.

As of July 2026, 8 countries had not yet eliminated maternal and neonatal tetanus: Afghanistan, Angola, the Central African Republic, Nigeria, Pakistan, Papua New Guinea, Somalia and Yemen.

Countries that eliminate the disease must keep up routine vaccination of pregnant women and children, access to clean births and good surveillance. WHO also notes a higher risk in adolescent and adult males who are circumcised, because immunity fades and many countries offer males few chances to get boosters.

To learn more about the vaccines that also protect against tetanus, read about diphtheria and whooping cough. UNICEF is one of the agencies that launched the elimination initiative.

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