Tetanus vaccine

Key points about tetanus vaccine

  • The tetanus vaccine protects against tetanus infection.
  • In Aotearoa New Zealand the tetanus vaccine is also called Infanrix–hexa®, Infanrix–IPV®, Boostrix® and Adacel® .
  • Find out about the vaccines and possible side effects
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The tetanus vaccine is used to protect against tetanus infection. This is a serious disease caused by tetanus bacteria, which is found in soil and manure. If an adult or child has a cut exposed to soil, they could get tetanus. Other ways tetanus bacteria can get into your body are through:

  • open fractures where the skin is broken and the bone exposed
  • bite wounds
  • wounds that have foreign objects, eg, wood splinters
  • crush injuries
  • burns
  • body piercings and tattoos
  • eye injuries.

Tetanus affects your nervous system and causes severe muscle contractions, mainly of your jaw and neck muscles. Find out more about tetanus.

  • Vaccination is the best method for preventing tetanus infection. 
  • This doesn't stop the bacteria growing in a contaminated wound, but it provides protection against the harmful toxin released by the bacteria.
  • You can't get tetanus disease from the vaccine, as it doesn't contain live, active bacteria.

In Aotearoa New Zealand, the tetanus vaccine is given in combination with other vaccines as 1 injection and comes in different brands. These are Infanrix-hexa®, Infanrix-IPV®, Boostrix® and Adacel®.

Vaccination with 3 or more doses of a tetanus-containing vaccine is required for full protection, followed by booster vaccinations throughout life. 

As part of the New Zealand childhood immunisation schedule(external link), tetanus vaccine is offered free to: 

  • babies at 6 weeks, 3 months and 5 months as Infanrix-hexa®
  • children at 4 years as Infanrix-IPV®.  

Read more about childhood immunisation.

Getting the tetanus vaccine in childhood doesn't give you lifelong immunity as the effect of the vaccine wears off with time, so booster doses are needed.

Booster doses are free for:

  • children at 11 years of age
  • adults from 45 years of age who haven't previously received 4 doses of tetanus-containing vaccine
  • adults from 65 years of age unless they've already had a tetanus booster within the past 10 years.

Read more about immunisation for older children and immunisation for adults.

Boosters may also be needed after some cuts, grazes and wounds if it's been more than 5 years since the last booster. Adults who have never had a tetanus injection will need to have a course of 3 injections at least 1 month apart. 

It's recommended that pregnant women get the Boostrix vaccine during their second or third trimester. Read more about pregnancy and immunisation.

Tetanus vaccine is given by injection in combination with other vaccines, eg, diphtheria. It's given into a muscle.

Like all medicines, the tetanus vaccine can cause side effects, although not everyone gets them. 

Side effects What should I do?
  • Pain, swelling or redness around the injection site
  • This is quite common after having the vaccination.
  • It usually starts a few hours after getting the injection and settles within a few days.
  • Place a cold, wet cloth or ice pack where the injection was given. Leave it on for a short time. 
  • Don't rub the injection site.
  • Tell your doctor if this bothers you.
  • Read more: After your immunisation(external link).
  • Fever
  • This is quite common for the first 1 or 2 days after receiving the injection and usually settles within a few days.
  • Dress lightly, with a single layer of clothing.
  • Don't wrap your child in a blanket.
  • Keep the room cool and use a fan.
  • Drink plenty of fluids.
  • The routine use of paracetamol is not recommended following vaccinations, but may be used if your child is miserable or distressed.
  • Tell your doctor if the fever persists.
  • Read more: After your immunisation.(external link)
  • Feeling unwell, tired or weak
  • Loss of appetite
  • Muscle ache
  • Headache
  • These are quite common for the first 1 or 2 days after receiving the injection.
  • They usually settle within a few days.
  • Rest and drink plenty of fluids.
  • The routine use of paracetamol is not recommended following vaccinations, but may be used for relief of severe discomfort.
  • Tell your doctor if these bother you.
  • Read more: After your immunisation.(external link)
  • Signs of an allergic reaction such as skin rash, itching, blisters, peeling skin, swelling of your face, lips or  mouth, or problems breathing
  • Allergic reactions to tetanus vaccine are rare.
  • If you develop these signs within a few days of the vaccination, tell your doctor immediately or phone Healthline 0800 611 116.

Read more about medicines and side effects and reporting a reaction you think might be a side effect.

Funded and unfunded tetanus vaccines can be given by your nurse, doctor, healthcare provider, and some pharmacies.

Find a provider near you by following this link to the Healthpoint website(external link) and entering your address.

  • If you're eligible for a free vaccination, there won't be a cost for the tetanus vaccine, but there may be an administration fee.
  • If you're not eligible to get a free vaccination, you will need to pay.
  • Pharmacists who are trained vaccinators can administer the tetanus booster vaccine, Boostrix, to people aged 18 years and over, or 13 years and over if pregnant.
  • A small number of pharmacists who have done extended training can administer any vaccination on the National Immunisaton Schedule(external link), including those for babies. Always call your pharmacy ahead of time to find out if they offer this service, the cost and whether you need to make an appointment.

Vaccines on the National Immunisation Schedule(external link) are free. Other vaccines are only funded for people who are at particular risk of disease. You can choose to pay for vaccines that you're not eligible to receive for free.

Read more about who can give vaccinations and where to get vaccinated.

Tetanus(external link) The Immunisation Advisory Centre, NZ
Guidelines for the management(external link) of tetanus-prone wounds The Immunisation Advisory Centre, NZ

Brochures

5 questions to ask about your medications(external link) Health Quality and Safety Commission, NZ, 2019 English(external link), te reo Māori(external link)

References

  1. Tetanus(external link) Immunisation Handbook 2024, NZ

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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