Per Wikipedia:  “Tetanus, also known as lockjaw, is a bacterial infection characterized by muscle spasms. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. Each spasm usually lasts a few minutes and spasms occur frequently for three to four weeks. Spasms may be severe enough to cause bone fractures. Other symptoms of tetanus may include fever, sweating, headache, trouble swallowing, high blood pressure, and a fast heart rate. Onset of symptoms is typically three to twenty-one days following infection. Recovery may take months. About ten percent of cases prove fatal.

Tetanus is caused by an infection with the bacterium Clostridium tetani, which is commonly found in soil, saliva, dust, and manure. The bacteria generally enter through a break in the skin such as a cut or puncture wound by a contaminated object. They produce toxins that interfere with normal muscle contractions. Diagnosis is based on the presenting signs and symptoms. The disease does not spread between people.”

The CDC reports that between 2001 and 2008 there were an average of 29 cases of tetanus, at a 13.2% fatality rate.  Of those individuals that contracted tetanus, only 40.2% had never been vaccinated against tetanus toxoid.  The odds of US citizens contracting tetanus in any given year are less than 1 in 10,000,000.  The tetanus vaccine is effective for no more than ten years.

Vaccine Statistics

When debating informed consent, it is important that people calculate the risk versus the reward for all options.  Here are some facts, according to VAERS and the CDC.

  • Since 2000, there have been an average of 26 deaths annually from tetanus in the US.
  • Since 2000, there have been at least 1713 deaths reported to VAERS associated with the tetanus vaccine.
  • Since 2000, there have been 120,806 adverse events reported to VAERS, with the vast majority of them falling between the ages of 1-5 years.

With no other data, it is clear that children in the US face a greater risk of death from the tetanus vaccine than they do from tetanus itself due to its rarity.  As an endemic disease hosted in the environment and intransmissible between humans, vaccination rates have no effect on the public risk of contracting the disease.  As such, the tetanus vaccine is unique among other vaccines in that it has no public health implications.

There is no ambiguity in the calculation that the tetanus vaccine is more deadly than the risk of dying from tetanus by almost two orders of magnitude.  Since 2000, there have been an average of 3.8 million live births in the US annually.  With 92% vaccination rates across the country, this equates to approximately 3.5 million children being vaccinated per year, and 5 doses per “full vaccination”, leaving the odds of death at approximately 1 in 184,000 from receiving each dose of tetanus vaccine, or 1 in 37,000 from the entire series.  A 75 year old individual, in order to maintain full immunity throughout their life, would require 12 doses of tetanus vaccine, placing lifetime mortality risk from the vaccine at 1 in 15,000 as opposed to 1 in 39,000 from tetanus itself.  If the FDA’s assessment of reporting compliance is correct (<1%), these odds could be as low as 1 in 1840 for a single dose or 1 in 370 from the full series (1 in 150 lifetime risk for a 75 year old fully vaccinated individual), making it far more risky to get the vaccine than the negligible risk of contracting the disease.  The problem with this calculation, however, is that we simply do not know the true number of deaths attributable to the tetanus vaccine due to our faulty reporting system.  Other statistics (based on estimated numbers of doses administered per the above calculation) reported since 2000 (rate reported/rate possible per FDA) per dose:

  • 2528 immediately life threatening complications (1 in 108,000/1 in 1080)
  • 1686 permanent disabilities (1 in 175,000/1 in 10,750)
  • 15163 hospitalizations or extensions of hospitalization (1 in 17,700/1 in 177)
  • 39,323 emergency room or office visits related to complications (1 in 7200/1 in 72)

Some of the possible rates per the FDA are too chilling to want to believe, and to be perfectly honest, we are skeptical of them.  This is the greatest problem with estimating risk versus reward when real numbers are deliberately obscured.

The tetanus toxoid vaccine is not designed to prevent infection, but rather to limit damage from tetanus toxin released during infection.  As such, it will at best limit the severity of infection, and at worst have little protective effect.

Vaccine Safety

Vaccine Typepeptide antigen/partially immune

Pregnancy ClassC (TDaP)

This section will reference the product insert for TDaP as provided by the FDA.  The TDaP vaccine uses high levels of aluminum adjuvants.

Contraindications (do not vaccinate):

  • Allergy to any tetanus toxoid vaccine, or included component such as latex
  • Encephalopathy within 7 days of administration
  • Progressive or unstable neurological conditions
  • Immunosuppressed (such as with steroids) or immunocompromised individuals

Adverse Reactions (as reported by the manufacturer):

  • Injection site pain/swelling/erythema/bruising/abscess, fever, headache, body ache, muscle weakness, tiredness, chills, sore and swollen joints, nausea, lymphadenopathy, diarrhea, vomiting, rash, malaise, myalgia, anaphylaxis, angioedema, edema, hypotension, paresthesia, hypoesthesia, Guillain-Barré syndrome, brachial neuritis, facial palsy, convulsion, syncope, myelitis, myocarditis, pruritus, urticaria, myositis, muscle spasm, Arthus hypersensitivity, miscarriage (incidence rate increase of 200-500% according to statistics included in clinical testing information in the insert compared to national statistics provided by the March of Dimes), death.

Scientific Studies

Editor’s Opinion

Tetanus is a frightening and truly deadly condition to contract, often requiring months of rehabilitative care in those that have contracted it.  Even given this, there are few scenarios in which the tetanus vaccine will ever provide lower risk than potential reward (construction, farm-work, other jobs involving unsanitary conditions involving high risks and rates of minor skin-piercing injuries).  For children and adults subjected to those conditions, we would recommend receiving the vaccine.  For all other individuals, we do not recommend its administration.