Tetanus, Diphtheria, and Pertussis

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Tetanus Overview

What is tetanus?

Tetanus is a disease caused by Clostridium tetani bacteria. The bacteria are usually found in soil, dust, and manure and enter the body through breaks in the skin. It is not known to spread from person to person. Symptoms include difficulty swallowing and breathing and spasms in the muscles of the jaw, often called “lockjaw.”

Read more about tetanus and how it affects people on the Centers for Disease Control and Prevention (CDC) website.

What are the symptoms of tetanus?

Tetanus has the following symptoms:

  • Jaw cramping
  • Sudden, involuntary muscle spasms
  • Painful muscle stiffness all over the body
  • Trouble swallowing
  • Seizures (jerking or staring)
  • Headache
  • Fever and sweating
  • Changes in blood pressure and heart rate

Tetanus can lead to more serious issues, such as broken bones, blood clots, aspiration pneumonia, and breathing difficulty. One to two out of 10 people who have tetanus die.

Who is at risk?

People may be more at risk if they:

  • Are 60 years of age or older.
  • Have diabetes.
  • Have a history of immunosuppression.
  • Use intravenous drugs.

Nearly all cases of tetanus in the United States today are from people who never received a tetanus vaccine or didn’t stay up to date on booster doses.

Limit the spread of tetanus

Vaccination is the best way to prevent tetanus infection.

People should apply first aid to even minor, non-infected wounds like blisters, scrapes, or any break of skin to prevent infection.

Wash your hands often with soap and water or use an alcohol-based hand rub if washing is not possible.

Be aware of your environment and where you step.

Diphtheria Overview

What is diphtheria?

Diphtheria is a highly contagious disease caused by the Corynebacterium diphtheriae bacteria, which releases toxins in the body. Symptoms include weakness, sore throat, mild fever, and swollen glands in the neck. The disease is spread through respiratory droplets, like from coughing or sneezing. People can also get sick from touching infected open sores or ulcers.

Read more about Diphtheria and how it affects people on the Centers for Disease Control and Prevention (CDC) website.

What are the symptoms of diphtheria?

Respiratory diphtheria has the following symptoms:

  • Weakness
  • Sore throat
  • Mild fever
  • Swollen glands in the neck
  • Gray coating in nose and throat

Respiratory diphtheria can cause nerve or heart muscle damage, airway blockage, kidney failure, and death. Without treatment, respiratory diphtheria will kill up to half of all people who get infected. Even with treatment, one in 10 people may die.

Diphtheria infections of the skin can cause the following symptoms:

  • Open sores or ulcers
  • Redness, swelling, or pain

Diphtheria infections of the skin do not usually cause serious complications.

Who is at risk?

Children under five years of age and adults over 40 are more at risk for severe complications and death from diphtheria.

Limit the spread of diphtheria

Vaccination is the best way to stop diphtheria infections. All people, including travelers to foreign countries, should get vaccinated.

If you live in a household with someone sick from diphtheria, avoid close contact and do not touch items or surfaces that may be infected with diphtheria. Close contacts may receive antibiotics to prevent them from getting sick.

Pertussis (Whooping Cough) Overview

What is whooping cough?

Whooping cough (pertussis) is a highly contagious disease caused by Bordetella pertussis bacteria. Infected babies may struggle to breathe, while teens and adults usually have mild symptoms that seem like the common cold. The disease is spread through respiratory droplets, like from coughing or sneezing.

Read more about whooping cough and how it affects people on the Centers for Disease Control and Prevention (CDC) website.

What are the symptoms of whooping cough?

Whooping cough starts with the following symptoms, which may resemble a cold:

  • Runny nose
  • Low-grade fever
  • Mild cough
  • Life-threatening pauses in breathing (apnea)
  • Turning blue or purple in babies and young children

As whooping cough progresses, symptoms may include:

  • Violent or rapid coughing fits.
  • Making a high-pitched “whoop” sound when inhaling after coughing.
  • Vomiting during or after coughing fits.
  • Struggling to breathe.
  • Tired after a coughing fit, but seem well in-between fits.

Who is at risk?

Babies and young children are more at risk for severe complications from whooping cough.

Limit the spread of whooping cough

Getting vaccinated against whooping cough is the best way to reduce the spread of whooping cough. Those who are vaccinated and get sick from whooping cough have less severe symptoms and recover quicker.

Because pertussis bacteria are easily transmitted in the air, people should avoid sharing spaces with those who are infected or are sick. Those who are sick should avoid close contact with babies if they can. Caregivers who have pertussis could spread it unknowingly, especially if they have not been vaccinated.

Cover your coughs or sneezes into a tissue, or an elbow or sleeve. Wash your hands with soap and warm water regularly. Get vaccinated. Taking antibiotics early during illness may shorten the amount of time someone is contagious.

Tetanus, Diphtheria, and Pertussis Vaccines

When do people get tetanus, diphtheria, and pertussis vaccines?

The Centers for Disease Control and Prevention (CDC) recommends tetanus, diphtheria, and pertussis vaccination for all ages. These three diseases are prevented by the following vaccines:

  • A childhood vaccine called DTaP
  • A childhood vaccine without the pertussis component called DT
  • An adolescent and adult vaccine called Tdap
  • An adult vaccine without the pertussis component called Td

The vaccine names are shorthand for the diseases they prevent. D for diphtheria, T for tetanus, and aP for acellular pertussis.

In children, DTaP vaccine is given at the following ages:

  • 1st dose at 2 months of age
  • 2nd dose at 4 months of age
  • 3rd dose at 6 months of age
  • 4th dose at 15 to 18 months of age
  • 5th dose at 4 to 6 years of age

Preteens between ages of 11 to 12 years should get a Tdap vaccine to boost their immunity.

If your child has a contraindication to the pertussis component of the DTaP vaccine, check with your doctor to see if your child should complete the series with Td vaccine instead. Contraindication to the pertussis component would include if your child developed coma, decreased level of consciousness, or prolonged seizures (encephalopathy) within 7 days of receiving DTaP.

In adults, those who have never received a Tdap vaccine should get one. This should be followed by a Td or Tdap vaccine every 10 years to boost immunity.

In pregnant people, Tdap should be given during the early part of the 3rd trimester of every pregnancy. By doing so, babies are protected from whooping cough in the first few months of life.

What are the side effects of DTaP, Tdap, and Td vaccines?


Most children experience minor or no side effects. The most common side effects of DTaP vaccine include:

  • Soreness or swelling where the vaccine was given.
  • Fever.
  • Fussiness.
  • Feeling tired.
  • Loss of appetite.
  • Vomiting.
  • Rarely, seizures, non-stop crying, or high fever over 105°F may occur.

Tdap, Td

Most people experience minor or no side effects. The most common side effects of Tdap vaccine include:

  • Pain, redness, or swelling where the vaccine was given.
  • Mild fever.
  • Headache.
  • Feeling tired.
  • Nausea, vomiting, diarrhea, or stomachache.

These vaccines are continually monitored for safety. The benefits and side effects of these vaccines outweigh the risk of getting tetanus, diphtheria, or pertussis.

Why are diphtheria, tetanus, and pertussis vaccines important?

Getting tetanus, diphtheria, and pertussis vaccines protects you against three bacterial diseases which can be very dangerous. Getting vaccinated protects yourself and the community around you, including those who can’t get vaccinated.

Of the three diseases, whooping cough is the most common. The United States still experiences outbreaks of whooping cough, and it can be life threatening to babies.

Vaccine Information Statement and Resources

The Vaccine Information Statement (VIS) is given to parents/guardians at the time of vaccination. It explains the benefits and risks of the specific vaccination.

  • Read the current DTaP VIS from the Centers of Disease Control and Prevention (CDC).
  • Read the current Tdap VIS from the CDC.
  • Read the current Td VIS from the CDC.

Additional resources for the public

Pertussis (Whooping Cough) page (CDC)

Additional resources for healthcare providers

Pertussis Vaccination page for Healthcare Providers (CDC)

About Young Children with a Contraindication to Pertussis Vaccines (CDC) 

Childhood Vaccine Program

The Washington State Childhood Vaccination Program provides vaccines to children 18 years of age and younger at no cost. Diphtheria, tetanus, and pertussis vaccines are included in this program.

View participating health care providers on the Department of Health’s Vaccine Provider Map.

Diphtheria, Tetanus, and Pertussis Vaccine Requirement for Schools

Diphtheria, tetanus, and pertussis vaccines are required for child care and school entry in the state of Washington. Learn more about school and child care immunization requirements by visiting the family friendly school immunization requirements webpage.