Can You Treat Tetanus Without a Tetanus Shot?

Why would anyone want to try and treat tetanus without a tetanus shot?

That’s a good question…

Misinformation about tetanus from the PIC.

Why would a doctor tell others that tetanus could be treated without a tetanus shot?

That might be a question for a state medical board…

Can You Treat Tetanus Without a Tetanus Shot?

As most people will notice, even looking at the ironically named Physicians for Informed Consent’s own post, you don’t treat tetanus without a tetanus shot.

“Tetanus is a medical emergency requiring hospitalization, immediate treatment with human tetanus immune globulin (TIG), agents to control muscle spasm, aggressive wound care, antibiotics, and a tetanus toxoid booster. If tetanus immune globulin is unavailable, Immune Globulin Intravenous (IGIV) can be used.”

CDC on Tetanus for Clinicians

Even in the study that they used as a reference clearly used both tetanus immune globulin and a tetanus shot.

What might be confusing to some folks, is that tetanus toxoid, is synonymous (has the same meaning) as:

  • tetanus vaccine
  • tetanus shot
  • Td (tetanus toxoid + diphtheria toxoid)

So like most people with tetanus, this patient received both tetanus immune globulin and a tetanus vaccine, a fact I tried to point out so that visitors to Physicians for Informed Consent could get true informed consent about their vaccine choices.

The comment that got me banned from posting on Phyicians for Informed Consent.
As often happens on anti-vaccine sites, my comment was quickly deleted and I was banned from posting further messages.

And fortunately, the patient, who’s previous immunization history was unknown, got better!

Treating Tetanus With a Tetanus Shot

Why did he have tetanus?

The case they are talking about occurred in Japan, and again, it isn’t known if the patient had ever received a tetanus vaccine.

“In Japan, tetanus toxoid was introduced in 1968, so elderly adults who were born before 1968 have high risk of tetanus.”

Tomoda et al. on Tetanus without apparent history of trauma

He was born in 1950 and although he had no history of recent trauma, “he grew vegetables in a field as his hobby.”

As most people know, gardening is a risk factor for getting tetanus.

And with such a long incubation period, it is very likely that he had a minor wound or injury while gardening, was exposed to tetanus spores, and later developed tetanus symptoms.

Over 100 years ago, we did treat tetanus with just tetanus immunoglobulin, but that was before the tetanus vaccine was developed.
Over 100 years ago, we did treat tetanus with just tetanus immunoglobulin, but that was before the tetanus vaccine was developed.

The long incubation period is also the reason that giving a tetanus vaccine works to prevent you from getting tetanus even after you have been exposed. Tetanus spores have to germinate, the bacteria have to grow and then produce exotoxins. And then the exotoxins have to travel to different sites in your nervous system, where they act as neurotoxins.

Hopefully, before they do, the dose of tetanus vaccine you got when you pricked your finger on a thorn, stepped on a nail, or cut your leg, etc., will have already induced you to start making antibodies against the exotoxins – antitoxin. Just in case they don’t, in a high risk case, you also would have gotten a dose of tetanus immune globulin for an immediate dose of antitoxin – antibodies against the exotoxins.

The same thing happens if you have already developed tetanus symptoms. A dose of tetanus immune globulin helps to neutralize neurotoxins that haven’t already started doing damage, and you get supportive care until you recover. Plus antibiotics to kill the bacteria so they won’t make more exotoxins and a tetanus shot.

Why not just give tetanus immune globulin, as the post from Physicians for Informed Consent implied you can do?

It is mostly because a tetanus infection doesn’t stimulate any natural immunity and the immunity you get from tetanus immune globulin is temporary, so won’t prevent a relapsing or recurrent case.

Before the use of tetanus vaccines became standard, it was well known that tetanus relapses were possible.
Before the use of tetanus vaccines became standard, it was well known that tetanus relapses were possible.

And because no one would substitute a treatment that is known to work well, a tetanus vaccine with tetanus immune globulin, and switch it out for one that might be riskier and have no extra benefits.

Using immune globulin alone was once the recommended treatment. That was before the tetanus vaccine was developed though. Back then, in the late 19th century and early 20th century, folks with suspected tetanus got treated with anti-tetanic serum that was made in horses. The main problem with this tetanus antitoxin was that it could sometimes trigger serum sickness.

Fortunately, a tetanus vaccine was soon developed and it’s use with tetanus immune globulin helped make deaths from tetanus very rare.

Of course, tetanus is still around. Although it is a vaccine-preventable disease, it will never be eradicated, like smallpox.

“This case had no apparent portal of entry; there was no history of trauma, and no site was found on physical examination. However, this is not uncommon; no obvious entry site was reported in approximately 26% of cases in Japan.”

Tomoda et al. on Tetanus without apparent history of trauma

And not specific to Japan, that you can get tetanus without a history of trauma should be what really concerns folks in this article that the Physicians for Informed Consent has decided to spotlight.

It is a great reminder that vaccines are necessary.

More on Treating Tetanus Without a Tetanus Shot

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