I stepped on a nail. Do I need a tetanus shot?


Q: I stepped on a nail and am wondering if I need a tetanus shot.  My last shot was 5 years ago.

A: You should probably get a tetanus shot in this case.  Tetanus vaccines are given to children in the USA with a series of 5 childhood shots called the DTaP.  The vaccine covers diphtheria, tetanus, and pertussis.  A booster that contains vaccines to all three diseases is given between the ages of 11 and 18.  After that, it is recommended that adults get the Tdap booster vaccine every 10 years, and sooner (every 5 years) if there is an injury. 

Puncture wounds from objects like nails and bites are most susceptible to infection with tetanus. However, you can also get tetanus from any exposure to soil, including minor cuts, scrapes, and burns, and sometimes with no injury at all. 

Once the tetanus bacteria get into your tissues, it starts creating toxins.  These toxins interfere with nerves, which leads to spasms, contractions, and respiratory failure.  We take this disease seriously because it is potentially deadly but very preventable.

It is important to take care of a skin wound to prevent infection.  The first steps should be to clean the wound with soap and water.  Use an antibiotic cream and keep the wound covered with a bandage until it scabs over.  Remember to change the dressing daily or it becomes wet or dirty, and seek care if the wound is getting more red or painful, or if you have other concerns. 

FINAL SUMMARY – if you get hurt, consider getting a tetanus shot if it has been more than 5 years since your last booster, and keep your tetanus protection up-to-date every ten years. 

We provide the tetanus vaccine and many others here at the Student Health Center, so you can always come in and see us to get one.


Adam Brandeberry, Med IV (OSU COM)

Roger Miller, MD (OSU Preventive Medicine)


25 thoughts on “I stepped on a nail. Do I need a tetanus shot?

  1. i stepped on a nail while i was walking on rocks and it went through my bottom foot the nail was rusted im not sure if it was a nail or a screw i started bleeding not very much it didn’t really hurt i had some help i got it pulled out they helped me by cleaning my foot and putting antibiotic cream i had my tetanus shot given already when i was younger what do i do i am 15 years old?

    • Jorge,

      When you say that you received your tetanus shot when you were younger – what do you mean by younger? If it was more than 10 years ago, you should go to the doctor and get another tetanus shot. The Centers for Disease Control and Prevention recommends that individuals receive a tetanus vaccine every 10 years.

  2. I had a tetanus shot about a year ago and today I got stabbed with a nail but didn’t bleed nail was rusty, wondering if I would need another shot?

  3. I stepped on a nail although, not rusty a pretty good puncture. I am planning on getting a tetnus shot as it has been many years since my last, I’m 51. My question is, “would it hurt to wait until Monday to see my GP and save 100’s of dollars by not having to go to ER as it is Sat evening and my doctors office is not open.

  4. I do not know when my last tetanus shot was, but the other day I stepped on a needle in my room I squeezed it at the time to have some blood run out then sprayed peroxide on it. I forgot about it the day after and I tend to walk in my back yard barefoot. I have experienced lock jaw like symptoms but I tend to get that sometimes after forgetting to wear my retainer and also get neck pain and shoulder pain every now and then, but am experiencing it now. I get alittle scared sometimes. I am wondering if I should worry about tetanus. The wound site is small just like a needle point size and it looks closed but I can see it still.

    • Dude how long was the last time u got a tetanus shot because it might get infected so u probably might need to get a tetanus shot because it might have got infected when u went barefoot on your yard

  5. I had a tetanus shot about 4 year ago & today i stepped into a rusty nail but dosent bleed.do i need anethor tetanus shot?

  6. Hi I stepped on a rusty nail in a dirty apartment 3 days ago, since then my foot has swollen and the top of my foot is almost completely red, also my ancle and surrounding muscles ache and minor spasms. I haven’t had my tetanus shot in about 8 years. Could I be infected with tetanus within the first 24 hours??

  7. Hey yesterday I stripped on a really rusted nail at work and I squeezed some blood out …then when to the er to get a tetanus shot.today day my foot only hurts to walk but don’t look red out swollen.I’m not concern about infection but my question is do I really need the meds they prescribed me?I got prescribed levaquin and kefleks ..you think I can doo with out cause I feel fine just hurts to put pressure on my foot.

    • Levaquin is used to treat bacterial infections of the skin. Keflex fights bacteria in the body. These are preventative measures. If you wait until your foot hurts and is swollen and seeping puss to get treatment, it will require much more aggressive treatment. Better to take the preventive measures now and avoid possible infection.

  8. So I stepped on a nail yesterday. It didn’t bleed and is a really small mark on my foot but it still hurts to put weight on it. I dont know if I have had a shot before but I do t have insurance and dont want a big hospital bill. What should I do? Can I wait until I start having symptoms ? How long will it take to have any? And is there any sign I can look for to indicate if I am infected? Like redness or pain?

    • According to the Mayo Clinic website, the average incubation period for the tetanus bacteria is 7 to 8 days. The signs and symptoms of tetanus may appear anytime from a few days to several weeks after the bacteria has entered your body.

      Common signs and symptoms of tetanus, in order of appearance, are:

      Spasms and stiffness in your jaw muscles
      Stiffness of your neck muscles
      Difficulty swallowing
      Stiffness of your abdominal muscles
      Painful body spasms lasting for several minutes, typically triggered by minor occurrences, such as a draft, loud noise, physical touch or light

      Once tetanus toxin has bonded to your nerve endings it is impossible to remove. Complete recovery from a tetanus infection requires the growth of new nerve endings and can take up to several months.

      You do not need to go to the hospital to get a tetanus shot. Pharmacies often offer the vaccine. The cost would be the cost of the vaccine itself and an administration charge depending upon the requirements of the pharmacy.

  9. I stepped on a nail. I don’t think it went in but there is blood under my skin. I’m 17. Should I get a tetanus shot?

  10. I hope you respond 🙂

    I had an entire sewing needle (a handheld one) go into my leg today near my shin. It went down about 2″ deep. Because it still had thread on the end, my husband was able to pull it out. The needle itself wasn’t rusty or anything.

    I’ve had a tetanus shot about 3 years ago. I am going to be OK without another tetanus shot, right? The one they gave me 3 years ago was when my hand accidentally went through a glass window, so it should be the right one that lasts 10 years (or at least 5 years between injuries), right?

    Thanks in advance 🙂

    • The CDC recommends that you be re-vaccinated with tetanus every 10 years, so you would not need to get another tetanus vaccine at this time. Keep an eye the area and if it does not appear to be healing then go to the doctor and get it checked out.

  11. A rusty nail went through my shoe and slightly punctured the bottom of my foot earlier today. It looked clean, I couldn’t even tell it did anything until it started bleeding. I had a tetanus shot 7 years ago, should I be concerned?

    • The tetanus vaccination is recommended every 10 years, so your vaccination should be OK. Keep an eye on the wound. If it gets irritated or doesn’t appear to be healing, then get it checked out.

  12. i stepped on a thumbtacks with rust part in it.its been about 7 months now but the part where thumbtacks penetrated is now hurting.i wonder if its still the tetanus or something? ive done my tetans injection few weeks ago.

  13. Ive got my tetanus shot this day third day of my injury with a rusty nail is it fine for havin a tetanus shot at third day of injury? Hope you’ll response 🙂

  14. I scraped the palm of my hand with some wet rusty steel that was lying on the ground. The small wound was inflamed for a couple of days. Seven days later I woke up with a lacerated toungue and a stiff calf muscle. I was very tired and did not wake up when I bit my tongue. I periodically get jaw cramps. My last tetanus shot was in three years ago. Should I do anything.

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