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home : columns : dr. k May 24, 2016

3/24/2014 5:00:00 PM
Make sure to get a tetanus booster shot every 10 years

DEAR DOCTOR K: Earlier today I cut my finger on an old nail while doing a home improvement project. Do I need a tetanus shot? How soon?

DEAR READER: My advice is: Better safe than sorry. And getting tetanus will make anyone very sorry. I recommend that you contact your doctor immediately. This is especially true if the nail broke through your skin, and you are not sure when you had your last tetanus booster shot.

Tetanus, also called lockjaw, is a life-threatening bacterial infection. A tetanus infection may develop after almost any type of skin injury, major or minor. The bacteria live in dirt and on dirty metal objects -- like old nails.

Once inside the skin, tetanus bacteria multiply and produce a toxin that affects the body's nerves. This toxin causes severe muscle spasms, cramps and seizures. Spasms in the jaw muscles produce lockjaw: You cannot open your mouth. Spasms also occur in muscles of the throat, chest, abdomen, arms and legs. Most patients also get fever, blood pressure that swings between too high and too low, a fast heart rate, disturbances in the heart rhythm and sweating. If you don't receive proper treatment, you can die.

You can get symptoms as soon as one day after your injury, or as late as several months afterward. But since it could be just one day, the time to act is immediately.

You won't need a tetanus booster if you completed the primary tetanus series (usually done in childhood) and you are sure you have had a tetanus shot within the past five years. If it may have been more than five years since you had the booster, you will need one now. Most people can't remember when their last tetanus shot was. I can't, that's for sure. But my medical record contains the dates of all my immunizations, so I don't need a good memory. Check to see if your doctor has a record of all your immunizations, and ask for a copy.

If you're not sure whether you ever had the primary tetanus series, then you will be given tetanus immune globulin. This is a preparation of antibodies, or immune-fighting proteins, that are directed against the tetanus. You will also be given the tetanus shot. On top of that, you will then be scheduled for future shots to complete the primary tetanus vaccine series.

If you develop tetanus, you will be treated with antibiotics, tetanus immune globulin, anti-toxin and muscle relaxers.

To prevent tetanus in the future, everyone should get a tetanus booster once every 10 years for life. My last one was on Jan. 5, 2005. I know, because I looked it up in my medical record.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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