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CS230473F
DISEASES and the VACCINES THAT PREVENT THEM
Reviewed February 2013
Tetanus Symptoms
Tetanus is a bacterial disease. When the tetanus bacteria invade
the body through a wound, they produce a toxin, or poison, that
causes muscles to become tight, which is very painful. Tetanus
mainly afects the neck and abdomen. Tetanus is also known
as lockjaw because it often causes a persons neck and jaw
muscles to lock, making it hard to open the mouth or swallow.
It also can cause breathing problems, severe muscle spasms, and
seizure-like movements. Complete recovery can take months. If
left untreated, tetanus can be fatal.
Causes of Tetanus
Unvaccinated children can get tetanus just by playing outdoors
and getting cuts that become infected with the bacteria. Thats
because tetanus bacteria are common in soil. Tetanus is not like
any other vaccine-preventable disease. The main diference is that
tetanus enters the body through wounds. It cannot be passed from
person to person.
Parents may have heard this, and it is true: children can get
tetanus from stepping on a rusty nail, says Doug Campos-Outcalt
of the American Academy of Family Physicians. Of course, they
also can get it from other wounds as well. Deeper and more severe
wounds are more likely to become infected with tetanus.
Tetanus: The United States Story
In the United States, widespread vaccination against tetanus has
made the disease almost non-existent. Vaccination to prevent
tetanus began in the late 1940s. From 1947 through 1949, before
widespread use of the vaccine, an average of 580 cases of tetanus
and an average of 472 deaths from tetanus were reported.
Today, tetanus is uncommon in the United States, with an average
of 29 reported cases annually from 2000 through 2009. Nearly
all cases of tetanus are among people who have never received
a tetanus vaccine, or adults who dont stay up to date on their
10-year booster shots. More than half of the reported cases from
2001 through 2009 were among persons younger than 50 years of
age, but almost all of the fatal cases were in persons age 65
and older.
People of all ages can get tetanus, says Dr. Tejpratap Tiwari of the
Centers for Disease Control and Prevention (CDC). Beginning
tetanus vaccination on schedule and getting timely boosters is the
best way to make sure you keep yourself and your children safe.
Tetanus: The Global Story
Disease caused by a toxin from the bacteria is always possible for
people who are not vaccinated, because the tetanus bacteria are
present everywhere in our environment, says Dr. Vance Dietz of
CDCs Global Immunization Division. Because we have a very
safe and efective tetanus vaccine, parents dont need to worry
about seeing their child sufer from this disease.
Unfortunately, cases of tetanus are still common in other parts
of the world and it kills thousands of babies each year. In places
where birthing conditions are not sanitary, tetanus in newborns
is a real threat. The World Health Organization estimates that
58,000 newborns died of tetanus in 2010.
I have seen the tragedy tetanus causes in other countries.
It is very hard to forget seeing the babies who die from this
vaccine-preventable disease, says Dr. Dietz.
Tetanus Vaccine for Baby
Babies get DTaP vaccine to protect them from tetanus and two
other diseases caused by bacteria, diphtheria and whooping cough
(pertussis). DTaP vaccines are recommended at ages 2 months, 4
months, and
6 months, and at 15 through 18 months old. A DTaP booster is
recommended at age 4 through 6 years. To reduce the number of
shots needed at a vaccine visit, other vaccines have been
combined with DTaP. Your doctor can tell you more about
combination vaccines.
Because immunity to tetanus decreases over time, a booster shot
(Td) is recommended every 10 years to stay protected. Tetanus is
also part of the tetanus-diphtheria-pertussis vaccine (Tdap) that
everyone needs to receive one time. Tdap is recommended for all
11- or 12-year-olds. Anyone who does not get the Tdap vaccine
at that age should get one dose as a replacement for their 10-year
tetanus-diphtheria (Td) booster shot.
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Benefts of DTaP Vaccine
In addition to protecting from diphtheria
and pertussis (also known as whooping
cough), getting the vaccine to protect against
tetanus as recommended
Saves lives.
Prevents hospitalizations.
Getting DTaP as recommended also
Protects young children, for whom the
diseases prevented by this vaccine can be
especially serious.
Protects the community by reducing
the number of people who may spread
diphtheria or pertussis.
Risks of DTaP Vaccine
Mild side efects are fever, redness,
swelling or soreness at the site of the
injection, fussiness, tiredness or poor
appetite, or vomiting.
Moderate side efects are uncommon.
One out of 1,000 children may cry for 3
or more hours; 1 out of 14,000 children
may have a seizure; 1 out of 16,000
children may have high fever.
Severe side efects are rare. For example,
fewer than one in a million children have
a severe allergic reaction.
Selected References
Centers for Disease Control and
Prevention (CDC). Tetanus. In: Atkinson
W, Hamborsky J, McIntyre L, Wolfe S,
eds. Epidemiology and Prevention of
Vaccine-Preventable Diseases (The Pink
Book). 11th ed. Washington, DC: Public
Health Foundation, 2009. p. 273282. http://
www.cdc.gov/vaccines/pubs/pinkbook/
default.htm
CDC. Prevention of pertussis, tetanus, and
diphtheria among pregnant and postpartum
women and their infants: Recommendations
of the Advisory Committee on
Immunization Practices (ACIP). MMMR.
2008;57(04);147,51. http://www.cdc.gov/
mmwr/preview/mmwrhtml/rr5704a1.htm
Fair E, Murphy TV, Golaz A, Wharton M.
Philosophic objection to vaccination as a
risk for tetanus among children younger
than 15 years. Pediatrics. 2002;109(1):e1-3.
http://pediatrics.aappublications.org/
content/109/1/e2.long
Roper MH, Vandelaer JH, Gasse FL.
Maternal and neonatal tetanus. Lancet.
2007;370(9603):194759. http://www.who.
int/immunization_monitoring/resources/
Maternal_and_neonatal_tetanus_Seminar.
pdf
Roush SW, Murphy TV. Historical
comparisons of morbidity and mortality for
vaccine-preventable diseases in the United
States. JAMA. 2007;298:21552163. http://
jama.ama-assn.org/cgi/reprint/298/18/2155
World Health Organization: Maternal
and neonatal tetanus elimination. http://
www.who.int/immunization_monitoring/
diseases/MNTE_initiative/en/index.html
The Centers for Disease Control and Prevention,
the American Academy of Family Physicians,
and the American Academy of Pediatrics
strongly recommend vaccines.
800-CDC-INFO (800-232-4636)
http://www.cdc.gov/vaccines
