Tetanus: Symptoms, Causes and Do You Need a Booster Before Travel?

In short: Tetanus is a serious, potentially fatal illness caused by a toxin from bacteria that live in soil and animal manure and enter the body through wounds. It is not spread between people. In the UK, five doses of a tetanus-containing vaccine are considered to give long-term protection, but if you are travelling somewhere with limited medical care and your last dose was more than ten years ago, a booster is usually recommended.

This guide, written by a Ready Health prescribing pharmacist and based on UKHSA, NaTHNaC (TravelHealthPro) and NHS guidance, explains how tetanus is caught, its symptoms and how to check whether you need a booster before travel.

What is tetanus?

Tetanus is caused by Clostridium tetani, a bacterium whose spores are found in soil, dust and animal faeces worldwide. When spores get into a wound, they can multiply and release a toxin that affects the nerves controlling muscles. Because the bacteria are everywhere in the environment, the disease can never be eradicated – only prevented, through vaccination and good wound care.

How do you get tetanus?

Tetanus spores enter through broken skin. Wounds that carry a higher risk include:

• puncture wounds, especially in gardens, farms or other contaminated settings
• cuts or grazes contaminated with soil or manure
• animal bites and scratches
• burns
• wounds containing a foreign body, such as a splinter
• fractures where the bone has broken through the skin

Tetanus is not passed from person to person.

What are the symptoms of tetanus?

Symptoms usually appear between 4 and 21 days after infection, although the range can be from a day to several months. They include:

• stiffness of the jaw muscles, making it hard to open the mouth (often called "lockjaw")
• painful muscle spasms, which can affect the whole body
• difficulty swallowing or breathing
• fever, sweating, and a fast heart rate or changes in blood pressure

Tetanus is a medical emergency that needs hospital treatment, often in intensive care. If you think you might have symptoms of tetanus, call 999 or go to A&E, or seek emergency care if abroad.

Why does tetanus matter when travelling?

The bacteria are present everywhere, including the UK, but travel can increase the consequences of an injury. In some destinations, clean wound care, tetanus vaccine or tetanus immunoglobulin (an antibody treatment given after some high-risk injuries) may not be readily available. Activities that make injuries more likely include:

• trekking, climbing, cycling and adventure sports
• working on farms, with animals or in construction
• travel to remote or rural areas far from medical care

Do I need a tetanus booster before travel?

Under UK guidance:

In the UK, adults usually receive a combined tetanus, diphtheria and polio (Td/IPV) vaccine for travel boosters, so one injection updates all three.

How is tetanus vaccine given on the NHS schedule?

Tetanus protection is built into the routine childhood programme, using combined vaccines that also protect against other diseases:

• 6-in-1 vaccine at 8, 12 and 16 weeks, with a further dose at 18 months for children on the schedule introduced in January 2026
• 4-in-1 pre-school booster at around 3 years 4 months
• 3-in-1 teenage booster (Td/IPV) at around 14 years

A whooping cough vaccine is also offered in each pregnancy. If you are unsure what you have had, your GP practice may be able to check your records.

What should I do if I get a wound abroad?

1. Clean the wound thoroughly with clean running water and soap.
2. Cover it with a clean dressing.
3. Seek medical advice promptly, particularly for deep, dirty or puncture wounds, bites or burns, or if your vaccination history is incomplete or unknown.
4. For animal bites or scratches in countries where rabies occurs, seek urgent medical care, as rabies treatment may also be needed.

Depending on the wound and your vaccine history, you may be offered a tetanus vaccine dose, tetanus immunoglobulin, or both.

Frequently asked questions

How long does a tetanus vaccine last?

After five doses, protection is considered long-lasting in the UK. A ten-year booster is only advised for travel to places with limited access to medical care, or in some cases after an injury.

Can I get tetanus in the UK?

Yes, although it is rare because most people are vaccinated. Gardening injuries and injecting drug use are among the recognised routes.

Is the travel tetanus vaccine the same as the polio and diphtheria vaccine?

Yes. The adult booster used in the UK is a single combined injection protecting against tetanus, diphtheria and polio.

Does a rusty nail cause tetanus?

Rust itself does not cause tetanus. The risk comes from soil or manure contaminating a deep wound.

Key takeaways

• Tetanus enters through wounds and is not spread between people.
• Five doses of tetanus-containing vaccine give long-term protection in the UK.
• Travellers to areas with limited medical care should have a booster if their last dose was over ten years ago.
• Clean any wound well and seek medical advice for deep, dirty or bite wounds.

Sources and further reading

• TravelHealthPro (NaTHNaC): Tetanus
• UKHSA Green Book, Chapter 30: Tetanus
• NHS: Tetanus

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

Not sure if you are up to date before a trip? Ready Health in Standish offers travel health consultations for people across Wigan, Chorley, Horwich and Bolton, including a check of which boosters are appropriate for your plans. Book a travel health consultation or call 01257 676001.