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In 2019 there were only 4 cases of tetanus reported in England. The number is low because an effective tetanus vaccine is given as part of the NHS childhood vaccination programme.

Most people who get tetanus have either not been vaccinated against it or did not complete the entire vaccination schedule.

Tetanus bacteria can survive for a long time outside the body and are commonly found in soil and the manure of animals such as horses and cows.

If the bacteria enter the body through a wound they can quickly multiply and release a toxin that affects the nerves, causing symptoms such as muscle stiffness and spasms.

The bacteria can get into your body through:

Tetanus cannot be spread from person to person.

The symptoms of tetanus usually start around 4 to 21 days after infection. On average, they start after around 10 days.

The main symptoms of tetanus include:

  • stiffness in your jaw muscles (lockjaw), which can make it difficult to open your mouth
  • painful muscle spasms, which can make it difficult to breathe and swallow
  • a high temperature
  • sweating
  • a rapid heartbeat

If it's not treated, the symptoms can get worse over the following hours and days.

Contact a GP or visit your nearest minor injuries unit if you're concerned about a wound, particularly if:

  • it's a deep wound
  • there's dirt or something inside the wound
  • you have not been fully vaccinated for tetanus, or you're not sure if you have

A doctor will assess the wound and decide whether you need treatment and whether you need to go to hospital.

Go to your nearest A&E immediately, or call 999 for an ambulance, if you get severe muscle stiffness or spasms.

If a doctor thinks there's a chance you could develop tetanus from a wound, but you do not yet have any symptoms, they'll make sure your wound is thoroughly cleaned. They may also give you an injection of tetanus immunoglobulin.

If you have not been fully immunised for tetanus, or you're not sure whether you have, you may be given a dose of the tetanus vaccine. You may also be given antibiotics.

Tetanus immunoglobulin is a medicine containing antibodies that prevent the tetanus toxin working, stopping its effects on the nerves. It provides immediate, but short-term, protection from tetanus.

If you develop symptoms of tetanus, you'll usually need to be admitted to a hospital intensive care unit (ICU), where you may be given several different treatments. These could include tetanus immunoglobulin, antibiotics, and medicine to help muscle stiffness and spasms.

Most people who develop symptoms of tetanus do recover, but it can take several weeks or months.

The tetanus vaccine is given as part of the NHS childhood vaccination programme.

The full course of vaccination includes 5 injections, usually given on the following schedule:


If you're not sure whether you've had the full vaccination course, contact your GP surgery for advice. It's possible to fully vaccinate older children and adults who were not vaccinated when they were younger.

Tetanus is found throughout the world, so you should make sure you're fully vaccinated before travelling abroad.

Contact your GP surgery for advice if you're planning to travel abroad and have not been fully vaccinated against tetanus, or you're going to an area with limited medical facilities and your last vaccine dose was more than 10 years ago.

You'll be offered the 3-in-1 teenage booster. This injection, which also protects against diphtheria and polio, is usually free on the NHS.

If you've never had the tetanus vaccine before, you may be advised to have as many doses as possible before you travel. There should be a 1-month gap between each dose. If there's not enough time to have all the doses you need, you can complete the course when you return.

Read more about travel vaccinations.