# Is Tetanus still a problem?

**URL:** <https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826>\
**Category:** Factual Questions\
**Created:** [June 6, 2001, 7:07pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826 "2001-06-06T19:07:35Z")\
**Posts on this page:** 20\
**Page:** 1

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**Author:** ![curious\_george](https://avatars.discourse-cdn.com/v4/letter/c/b487fb/32.png) [@curious\_george](https://boards.straightdope.com/u/curious_george)\
**Post date:** [June 6, 2001, 7:07pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/1 "2001-06-06T19:07:35Z")

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What is the status of Tetanus disease (lockjaw) in the USA? I never hear about anybody dying from it, or hear it in the news, until today when I saw a headline that there is a shortage of the vaccine because one of the producers went out of business (link below).

I first thought about it a couple weeks ago when I had a bike accident and badly scraped my knee. I went to a doctor, and he checked to see when my last tetanus shot was, which was nine years ago. He said the vaccines are usually good enough for ten years, unless a person gets a big wound, so he didn’t give me a shot. However, I read about tetanus at web sites and they stressed the importance of keeping shots current since it is often a severe or deadly disease otherwise.

Has tetanus been almost eliminated in the USA, or do people die from it every year? How bad or rare is it?

[http://www.channel3000.com/sh/news/wisconsin/stories/news-wisconsin-80702420010606-100618.html](http://www.channel3000.com/sh/news/wisconsin/stories/news-wisconsin-80702420010606-100618.html)  
Some States Rationing Tetanus Vaccine Due To Nationwide Shortage

June 6, 2001 – The U.S. Centers for Disease Control and Prevention is recommending that only the most severely wounded and pregnant women get the vaccine…But each batch takes eleven months, so relief isn’t expected before year’s end.

[http://www.babyzone.com/drnathan/T/tetanus.asp](http://www.babyzone.com/drnathan/T/tetanus.asp)  
Tetanus is a very serious disease and can be fatal even when treated. Tetanus is still seen in children that have not been vaccinated and among some newborns whose mothers lack immunity to tetanus toxin. Tetanus also occurs in people in their 50s and 60s whose immunity has worn off.

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**Author:** ![Thing\_1](https://avatars.discourse-cdn.com/v4/letter/t/ce73a5/32.png) [@Thing\_1](https://boards.straightdope.com/u/Thing_1)\
**Post date:** [June 6, 2001, 8:02pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/2 "2001-06-06T20:02:52Z")

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Yes, tetanus is still a problem. Tetanus is caused by a bacteri (Clostridium tetani) that lives in soil. Vaccinating people has no effect on the reservoir of the bacteri that lives in the dirt, so if people stopped getting vaccinated, the incidence of tetanus would greatly increase. Fortunately the vaccine works. According to the CDC web site only 124 cases were reported in the USA during the time from 1995-1997. For more information do a google search using Clostridium tetani.  
John

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**Author:** ![Ike\_Witt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ike_witt/32/283_2.png) [@Ike\_Witt](https://boards.straightdope.com/u/Ike_Witt)\
**Post date:** [June 6, 2001, 8:13pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/3 "2001-06-06T20:13:45Z")

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Thanks for reminding me, I need to get a booster shot.

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**Author:** ![Smeghead](https://avatars.discourse-cdn.com/v4/letter/s/f1d935/32.png) [@Smeghead](https://boards.straightdope.com/u/Smeghead)\
**Post date:** [June 7, 2001, 12:04am UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/4 "2001-06-07T00:04:43Z")

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Realize, of course, that those 124 cases does _not_ include people who get stuck with something and then go get a shot. I’m sure there are plenty more of those. But, as has been said, the vaccine works, so that’s the last we hear of them.

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**Author:** ![barbitu8](https://avatars.discourse-cdn.com/v4/letter/b/839c29/32.png) [@barbitu8](https://boards.straightdope.com/u/barbitu8)\
**Post date:** [June 7, 2001, 12:14am UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/5 "2001-06-07T00:14:22Z")

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I’ve heard that 10 years is too long and that 5 years is more realistic. Last year my doctor at my annual physical asked me if I wanted any shots (intending to give me a flu shot, I guess). He’s an internist. I don’t remember when my last tetanus shot, but I told him at my first visit to him two years ago that it was 7 years ago. He replied that I still have time for that. So I never got it.

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**Author:** ![Yeah](https://avatars.discourse-cdn.com/v4/letter/y/dbc845/32.png) [@Yeah](https://boards.straightdope.com/u/Yeah)\
**Post date:** [June 7, 2001, 12:34am UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/6 "2001-06-07T00:34:34Z")

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Barbitu8: “I’ve heard that 10 years is too long and that 5 years is more realistic.”

No need to guess or rely on what your “hear.” Your tax dollars (if you pay U.S. taxes) pay for people to collect all the available evidence and come up with evidence-based recommendations.

From the tetanus chapter of “Epidemiology and Prevention  
of Vaccine-Preventable Diseases” Course Textbook, 6th Edition (2nd Printing, January 2001) (aka “The Pink Book”):

“Because of waning antitoxin titers, most individuals have antitoxin levels below optimal levels 10 years after the last dose of DTaP, DTP, DT, or Td. As a result, additional booster doses of tetanus and diphtheria toxoids (as Td) are required every 10 years to maintain protective antitoxin titers…More frequent boosters are not indicated and have been reported to result in an increased incidence and severity of local adverse reactions.”

available for free at [http://www.cdc.gov/nip/publications/pink/tetanus.pdf](http://www.cdc.gov/nip/publications/pink/tetanus.pdf)

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**Author:** ![JillGat](https://avatars.discourse-cdn.com/v4/letter/j/9fc29f/32.png) [@JillGat](https://boards.straightdope.com/u/JillGat)\
**Post date:** [June 7, 2001, 2:03am UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/7 "2001-06-07T02:03:59Z")

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Tetanus is a problem with older people who neglect to get booster shots. The old lady getting jooked by her rose bush, etc…  
I learned that when I took that CDC Vaccine-Preventable Diseases Course. - Jill

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**Author:** ![don\_t\_ask](https://avatars.discourse-cdn.com/v4/letter/d/e68b1a/32.png) [@don\_t\_ask](https://boards.straightdope.com/u/don_t_ask)\
**Post date:** [June 7, 2001, 2:17am UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/8 "2001-06-07T02:17:33Z")

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Just a tip. I have my booster shots on my birthday every decade 1990, 2000. Easy to remember. Looking forward to 2010.

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**Author:** ![YWalker](https://avatars.discourse-cdn.com/v4/letter/y/6f9a4e/32.png) [@YWalker](https://boards.straightdope.com/u/YWalker)\
**Post date:** [June 7, 2001, 2:45am UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/9 "2001-06-07T02:45:32Z")

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I had always heard that you should get your tetanus shot updated every ten years.

I went in for a physical last month, and since it has now been 11 years since my last tetanus shot, I asked for a booster. My doctor told me that due to the shortage, he couldn’t get his hands on any vaccine. He said that most of the supplies were being reserved for people who came in with a really messy wound rather than as a preventative measure.

I feel really secure now…

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**Author:** ![jester21](https://avatars.discourse-cdn.com/v4/letter/j/ed655f/32.png) [@jester21](https://boards.straightdope.com/u/jester21)\
**Post date:** [June 7, 2001, 2:50am UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/10 "2001-06-07T02:50:22Z")

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…if yer as injury prone as me, you end up getting a shot about every 2-5 years anyways ;o)

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**Author:** ![Yeah](https://avatars.discourse-cdn.com/v4/letter/y/dbc845/32.png) [@Yeah](https://boards.straightdope.com/u/Yeah)\
**Post date:** [June 7, 2001, 3:31am UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/11 "2001-06-07T03:31:57Z")

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“…if yer as injury prone as me, you end up getting a shot about every 2-5 years anyways ;o)”

If yer as injury prone and not going to a very knowledgeable health care provider.

You never need a tetanus booster sooner than 5 years after the last one. See [http://www.cdc.gov/nip/publications/pink/tetanus.pdf](http://www.cdc.gov/nip/publications/pink/tetanus.pdf)  
or ask JillGat

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**Author:** ![Holly](https://avatars.discourse-cdn.com/v4/letter/h/48db29/32.png) [@Holly](https://boards.straightdope.com/u/Holly)\
**Post date:** [June 7, 2001, 11:48am UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/12 "2001-06-07T11:48:04Z")

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When I worked at an animal hospital, I saw a doberman die of tetanus. Definitely not a good way to go.

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**Author:** ![Zarathustra](https://avatars.discourse-cdn.com/v4/letter/z/898d66/32.png) [@Zarathustra](https://boards.straightdope.com/u/Zarathustra)\
**Post date:** [June 7, 2001, 12:06pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/13 "2001-06-07T12:06:48Z")

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[Ready for some lockjaw?](http://www.salon.com/tech/feature/2001/03/08/tetanus/index.html)

> [@](#):
>
> _from [Salon.com](http://Salon.com)_  
> Tetanus is one of those diseases whose onset is marked by symptoms so mild they’re almost sinister: fatigue, soreness, irritability. A few days later, when the patient notices a stiffness around the jaw, and a labored breathing, it’s often too late. As swallowing becomes difficult, the mouth fuses shut while the rest of the body is racked with muscle spasms so severe that a patient can break his or her bones.
> 
> You don’t quickly forget photos of tetanus patients, their faces frozen into something that would look like a smirk – eyebrows raised, the corners of the mouth turned up into a smile – if it didn’t give off the distinct impression of a physical prison; tetanus patients look, literally, trapped in their own faces. Later, their bodies become fortresses too; tetanus stiffens the entire body into positions you wouldn’t want to spend five minutes in. One photo shows a man bent backward into a crescent moon shape; another has a child’s arms bent up at the elbows, like a boxer getting ready to punch, but immobile. The people in these photos look scared.
> 
> Dr. William Muraskin, author of “The Politics of International Health” and assistant chairman of graduate studies at Queens College, says, “If you have tetanus, you die.” He’s exaggerating, but not by a lot: In developed nations, about two-thirds of those infected with tetanus die, with those who catch the illness quickly more likely to survive. Recovery for tetanus can take months, during which time the patient is treated with a medical arsenal that’s almost as scary as the disease itself: muscle relaxants, or medically induced temporary paralysis, weeks spent isolated in dark, silent rooms intended to reduce stimulation to the nervous system.

After reading this, I went out and got a booster shot the following week.

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**Author:** ![don\_willard](https://avatars.discourse-cdn.com/v4/letter/d/a88e57/32.png) [@don\_willard](https://boards.straightdope.com/u/don_willard)\
**Post date:** [June 7, 2001, 2:33pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/14 "2001-06-07T14:33:15Z")

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What are titers?

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**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\
**Post date:** [June 7, 2001, 3:36pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/15 "2001-06-07T15:36:55Z")

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Titer, or titre refers to the concentration of something, as measured by titration. A low titer means a low concentration.

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**Author:** ![JillGat](https://avatars.discourse-cdn.com/v4/letter/j/9fc29f/32.png) [@JillGat](https://boards.straightdope.com/u/JillGat)\
**Post date:** [June 9, 2001, 7:25pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/16 "2001-06-09T19:25:36Z")

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[[He said that most of the supplies were being reserved for people who came in with a really messy wound rather than as a preventative measure.]]

I think this is irresponsible advice. Call your local public health office and maybe you can get immunized there.

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**Author:** ![Yeah](https://avatars.discourse-cdn.com/v4/letter/y/dbc845/32.png) [@Yeah](https://boards.straightdope.com/u/Yeah)\
**Post date:** [June 9, 2001, 9:29pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/17 "2001-06-09T21:29:48Z")

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YWalker: “I went in for a physical last month, and since it has now been 11 years since my last tetanus shot, I asked for a booster. My doctor told me that due to the shortage, he couldn’t get his hands on any vaccine. He said that most of the supplies were being reserved for people who came in with a really messy wound rather than as a preventative measure.”

JillGat" “I think this is irresponsible advice. Call your local public health office and maybe you can get immunized there.”

According to the Centers for Disease Control and Prevention (CDC): “To assure vaccine availability for priority indications (2), all routine Td boosters in adolescents and adults should be delayed until 2002. Td use should follow existing recommendations for all other indications, which include 1) persons traveling to a country where the risk for diphtheria is high\*; 2) persons requiring tetanus vaccination for prophylaxis in wound management; 3) persons who have received \<3 doses of any vaccine containing tetanus and diphtheria toxoids; and 4) pregnant women who have not been vaccinated with Td during the preceding 10 years.” MMWR for May 25, 2001 / 50(20);418,427 “Notice to Readers: Deferral of Routine Booster Doses of Tetanus and Diphtheria Toxoids for Adolescents and Adults” found at [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5020a8.htm](http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5020a8.htm) see also errata at [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5022a6.htm](http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5022a6.htm)

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**Author:** ![Zarathustra](https://avatars.discourse-cdn.com/v4/letter/z/898d66/32.png) [@Zarathustra](https://boards.straightdope.com/u/Zarathustra)\
**Post date:** [June 9, 2001, 10:17pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/18 "2001-06-09T22:17:29Z")

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Glad I got my shot when I did. Now I can go play in the junkyard without fear . . .

. . . 'cept for the rats, of course. We’re not running out of rabies vaccine, are we?

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**Author:** ![don\_willard](https://avatars.discourse-cdn.com/v4/letter/d/a88e57/32.png) [@don\_willard](https://boards.straightdope.com/u/don_willard)\
**Post date:** [June 11, 2001, 2:39pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/19 "2001-06-11T14:39:28Z")

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Why is there an asterisk at “diphtheria”? Is this because when you get a tetanus shot you also get diphtheria?

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**Author:** ![Yeah](https://avatars.discourse-cdn.com/v4/letter/y/dbc845/32.png) [@Yeah](https://boards.straightdope.com/u/Yeah)\
**Post date:** [June 11, 2001, 6:55pm UTC](https://boards.straightdope.com/t/is-tetanus-still-a-problem/67826/20 "2001-06-11T18:55:30Z")

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“Why is there an asterisk at “diphtheria”? Is this because when you get a tetanus shot you also get diphtheria?”

Yes

From the diptheria chapter of the CDC’s “pink book”: [http://www.cdc.gov/nip/publications/pink/dip.pdf](http://www.cdc.gov/nip/publications/pink/dip.pdf)  
“Single antigen diphtheria toxoid is not available. Diphtheria toxoid is available combined with tetanus as pediatric DT or adult Td, and with both tetanus toxoid and acellular pertussis vaccine as DTaP. Combination diphtheria and tetanus toxoids and whole cell pertussis vaccine (DTP) is available but is no longer recommended.”
