Tetanus

Key facts

  • Tetanus is a rare but serious disease of the nervous system. It is caused by bacteria that are mostly found in soil, manure and dust.

  • It causes severe muscle contractions and affects the muscles used for breathing.

  • Overall, about 13% of people who catch tetanus in Australia will die. The risk is greatest for people who are very young and older people.

  • In Australia, all infants and young children are recommended to be vaccinated against tetanus. To keep this level of protection for adolescents, a booster dose is recommended for all 12- and 13-year-olds. This booster is the best way to protect adolescents from tetanus.

Last updated on 13 August 2025.

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When to vaccinate against tetanus

It is recommended that your adolescent receives a booster vaccination against tetanus at 12–13 years.


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What is tetanus?

Tetanus is sometimes called ‘lockjaw’. This is because the bacteria that cause tetanus can cause the muscles we use for chewing to lock or become stiff. This makes it difficult to swallow or chew. Tetanus can also affect all the muscles of the body, including the ones used for breathing. The bacteria live in soil, dust or manure. This means people can get tetanus through a cut, a burn, a bite or even just a prick from a nail or a thorn.1

What will happen to my adolescent if they catch tetanus?

Usual symptoms

  • Tetanus often starts with a stiff jaw or neck, with pain in the neck, shoulder and back muscles.
     

Common symptoms

  • Some people get violent, painful spasms (cramps) in all the muscles of their body. These spasms and cramps can be so strong that they break bones or tear muscles. They can also affect the muscles in a person’s throat, preventing them from breathing, and stop their hearts from beating properly.
     

Rare symptoms

  • Tetanus can also cause lung infection (pneumonia) and blood clots.
  • About 13% of people who catch tetanus in Australia will die. Most tetanus in Australia occurs in older people, but newborns are especially vulnerable if they catch tetanus.2

If your adolescent is tested and diagnosed with tetanus, your local state or territory Public Health Unit (PHU) will be notified. The PHU can provide advice on how to manage your adolescent’s tetanus condition.

What vaccine will protect my adolescent against tetanus?

In Australia, adolescents are recommended a combination vaccine (dTpa) that strengthens immunity to tetanus as well as diphtheria and whooping cough (pertussis).

This vaccine is also offered to infants, small children and pregnant adults.

When should my adolescent be vaccinated?

Adolescents are recommended to get a booster dose of a vaccine that protects against tetanus at 12–13 years of age (year 7 or equivalent). This booster extends the protective level of tetanus immunity from childhood into their adult years.

This dose is usually free at school.

Your adolescent can also receive this routine vaccine through a clinic visit with other immunisation providers. This visit may incur a fee.

Even if your adolescent is mildly unwell on the day of their appointment (this means no fever and a temperature under 38.5°C), they can still receive the vaccine.

How do tetanus vaccines work?

The vaccine works by ‘training’ your adolescent’s immune system to recognise and get rid of the tetanus bacteria and their toxins. The vaccine contains antigens, which are tiny, harmless fragments of the tetanus toxin. 

When your adolescent’s immune system detects the antigens in the vaccine, it produces antibodies. These antibodies are like soldiers that recognise and remember the tetanus toxin. If your adolescent is ever exposed to the real tetanus bacteria and their toxins, their immune system will recognise it quickly and fight it off using the antibodies created after vaccination.3

The tetanus vaccine does not contain any blood products and is not a ‘live’ vaccine. The antigens are made synthetically and are not the real bacteria. They cannot replicate themselves or cause disease.

How effective are tetanus vaccines?

A booster dose of a tetanus vaccine protects more than 97% of adolescents and adults against tetanus.4

To keep your adolescent’s protection against tetanus, they may need further boosters as an adult.4

Will my adolescent catch tetanus from the vaccine?

No, there is no risk that your adolescent will catch tetanus because the vaccine does not contain the live bacteria that cause the disease.

What are the common reactions to the vaccine?
  • Up to 77% of adolescents who get a booster dose of a vaccine that protects against tetanus, whooping cough and diphtheria can experience mild discomfort or pain where the injection was given. This can last one or two days after receiving the vaccine.5  
  • Less than 3% of adolescents who get a booster dose of a vaccine that protects against tetanus, whooping cough and diphtheria experience a high temperature or fever.5
Are there any rare and/or serious side effects to the vaccine?
  • The tetanus vaccine is a combination vaccine that also protects against whooping cough. Very rarely (less than 2%), adolescents can experience extensive limb or arm swelling after receiving a booster dose of a vaccine that protects against whooping cough. This reaction usually happens within 48 hours of vaccination, lasts for 1–7 days and then resolves completely.6
  • Up to 0.0005–0.001% of tetanus vaccine doses given (or 0.5–1 in 100,000 doses given) are linked to a swelling or inflammation of a nerve in the arm (brachial neuritis), which causes weakness or numbness.7,8 The seriousness and length of time of this reaction varies on a case-by-case basis.
  • About 0.0001% (1 in 1,000,000) of people have an allergic reaction following vaccination that affects their whole body; this is called anaphylaxis. This reaction usually happens within 15 minutes of receiving a vaccine. It can be treated with an injection of adrenaline. People who have this reaction usually recover quickly and don’t experience any long-term effects.9

If your adolescent doesn’t seem to be getting better or you are worried about them, you can get help: 

  • from your doctor
  • at your nearest emergency department
  • by calling Healthdirect on 1800 022 222.
What impact has vaccination had on the spread of tetanus?

Rates of tetanus cases began to reduce after the introduction of a tetanus vaccine in 1953. The disease is now very rare in Australia.2,10,11

graph: What impact has vaccination had on the prevalence of tetanus?

Sources: (i) Chiu C, Dey A, Wang H et al. Vaccine preventable diseases in Australia, 2005 to 2007. Communicable Diseases Intelligence 2010;34:S1-167; (ii) Australia’s notifiable disease status, 2010: annual report of the National Notifiable Diseases Surveillance System. Communicable Diseases Intelligence 2012;36:1-69

What if I still have questions?

You can read some answers to common questions here.

If you still have some questions about vaccinations for your adolescent, write them down and make an appointment with your nurse, your doctor or your health worker so you can ask them.

Please note: In SKAI Adolescent, the phrase ‘your adolescent’ or refers to all guardian relationships where health decisions for an adolescent fall under your responsibility.

Drafts of this page were reviewed by members of our Consumer Advisory Group.


  1. Australian Technical Advisory Group on Immunisation. Australian Immunisation Handbook. Canberra: Australian Government Department of Health and Aged Care; 2025. Available from: http://immunisationhandbook.health.gov.au
  2. Morris ES, Dey A, Vette K et al. Australian vaccine preventable disease epidemiological review series: tetanus 2003–2019. Communicable Diseases Intelligence 2023;47
  3. Australian Academy of Science. The science of immunisation: questions and answers. 2021. Available from https://www.science.org.au/education/immunisation-climate-change-genetic-modification/science-immunisation
  4. World Health Organization. Tetanus vaccines: WHO position paper – February 2017. Vaccine2018;36:3573-5
  5. Pichichero ME, Rennels MB, Edwards KM et al. Combined tetanus, diphtheria, and 5-component pertussis vaccine for use in adolescents and adults. JAMA 2005;293:3003-11. Erratum appears in JAMA 2005;294:3092
  6. Mertsola J, Van Der Meeren O, He Q et al. Decennial administration of a reduced antigen content diphtheria and tetanus toxoids and acellular pertussis vaccine in young adults. Clinical Infectious Diseases 2010;51:656-62
  7. Hamati-Haddad A, Fenichel GM. Brachial neuritis following routine childhood immunization for diphtheria, tetanus, and pertussis (DTP): report of two cases and review of the literature. Pediatrics1997;99:602-3
  8. Institute of Medicine. Stratton KR, Howe CJ, Johnston RB, Jr. (Eds). Adverse events associated with childhood vaccines: evidence bearing on causality. Washington, DC: National Academy Press; 1994
  9. McNeil MM, Weintraub ES, Duffy J et al. Risk of anaphylaxis after vaccination in children and adults. Journal of Allergy and Clinical Immunology 2016;137:868-78
  10. Chiu C, Dey A, Wang H et al. Vaccine preventable diseases in Australia, 2005 to 2007. Communicable Diseases Intelligence 2010;34:S1-167
  11. Australia’s notifiable disease status, 2010: annual report of the National Notifiable Diseases Surveillance System. Communicable Diseases Intelligence 2012;36:1-69