Tag: herd immunity

5 Myths About Tetanus and Tetanus Shots

Think you know everything you need to know about tetanus and tetanus shots to make an informed decision about getting vaccinated?

Unfortunately, there is a lot of misinformation out there about tetanus that can scare you away from getting a tetanus shot or make you think that you don’t really need one.

You can only get tetanus from a rusty nail. (False)

Would a rose smell as sweet if you pricked your finger on a thorn and got tetanus?
Would a rose smell as sweet if you pricked your finger on a thorn and got tetanus? Photo by Cherrie Mio Rhodes. (CC BY 2.0)

Tetanus is caused by the Clostridium tetani bacteria.

Unlike most other vaccine-preventive diseases, tetanus is not contagious. Instead, you can get tetanus after being exposed to tetanus spores in dust, soil, and feces, which then grow and make a powerful neurotoxin. Tetanus spores can even be found in the mouth of many animals.

So why does everyone associate tetanus with rusty nails?

We likely think that an old, rusty nail  is more likely to be contaminated with tetanus spores simply because it has been outside for a long time. Especially as compared to a brand new one that you just took out of a box.

But tetanus is not just about nails.

You can get tetanus after a cat or dog bite, a burn, frostbite, a tractor falling on your leg (crush injury), or falling into a rose bush (puncture wounds from thorns), etc. Almost anything that can cause a non-superficial wound can cause tetanus, especially if the wound is contaminated with dirt, feces, or saliva.

A tetanus shot won’t help after you have already been cut, stabbed, or bitten. (False)

The reason we give the shot is because the tetanus spores take time to germinate.

We are not worried about tetanus bacteria on a rusty nail, cat teeth, rose bush, or on ones very dirty hands through which a clean knife went through.

It’s the tetanus spores on those things and everywhere else, because they are in dirt and dust. And then, after the spores germinate inside a wound, the C. tetani bacteria have to start producing the exotoxin that acts as a neurotoxin, which causes the symptoms of tetanus.

The tetanus vaccine is against this exotoxin.

Unfortunately, it only takes a very small amount of tetanus toxin to cause tetanus. That’s why you don’t get natural immunity after being exposed to tetanus, but you do after getting the vaccine. It would only take about 60 nanograms of tetanus toxin to kill a small child.

Once the spores germinate, start producing exotoxin, and the exotoxin finally reaches your nervous system, that’s when you will start having tetanus symptoms.

If a puncture wound bleeds a lot, then you don’t need to get a tetanus shot. (False)

Many puncture wounds do not bleed a lot, but those that do are still at risk for tetanus.
Many puncture wounds do not bleed a lot, but those that do are still at risk for tetanus. Photo by James Heilman, MD

You don’t need to get a tetanus shot if you have a clean, minor wound and:

  • you have completed a primary tetanus series (a minimum of 3 tetanus containing vaccines), and
  • your most recent dose of tetanus vaccine was within the past 10 years

For most other wounds, including dirty wounds, animal bites, and puncture wounds, etc., you likely don’t need a tetanus shot if you have completed a primary tetanus series, and your most recent dose of tetanus vaccine was within the past 5 years.

In addition to a dose of tetanus vaccine, if has been less than 5 years since their last dose or they are unvaccinated or incompletely vaccinated, then they might also need to get tetanus immune globulin (TIG).

How much the wound bleeds has nothing to do with whether or not you need a tetanus shot. After all, a bleeding wound is not going to flush out all of the tetanus spores that might have contaminated your wound, or at least you have no guarantee that it did. What if the bleeding was more superficial and there was a deeper puncture wound that you couldn’t see?

This idea likely comes from the fact that tetanus is an anaerobic bacteria, meaning that it can’t survive around oxygen.

Tetanus is a mild disease. (False)

Tetanus, which people commonly think of as “lockjaw” is hardly a mild disease.

According to the CDC, “Even with modern intensive care, generalized tetanus is associated with death rates of 10% to 20%.”

And tetanus will always be a problem – if you aren’t vaccinated.

Since tetanus isn’t contagious and the tetanus spores are in the dirt and dust around us, you can’t rely on the folks around you to get vaccinated and “hide in the herd” for this vaccine-preventable disease.

Some recent cases highlight this myth:

  • an unvaccinated 7-year-old in Australia who contracted tetanus through an open wound in her foot while playing in her family’s garden. She was in critical condition, remained in the ICU for a few weeks despite quick treatment, and will likely face months, if not years of rehab after being released. (2017)
  • an unvaccinated women who developed obstetric tetanus
  • an unvaccinated 6-year-old in Canada who developed tetanus symptoms 10 days after stepping on a nail (2015)
  • unvaccinated children in parts of the world where vaccines are not longer available, like Ukraine
  • an unvaccinated 7-year-old in New Zealand who developed tetanus after cutting his foot and was hospitalized for almost a month (2013)

Worldwide, there are still about 49,000 deaths a year from neonatal tetanus and 14,500 deaths in children and adults. The incidence of tetanus has dropped tremendously since 1980 though, as more and more people get vaccinated throughout the world.

There are easy, non-toxic ways to prevent tetanus.

This one is actually true, it’s called a tetanus vaccine.

It replaced the previous treatment for tetanus, giving folks tetanus antitoxin, a treatment which began in the late 19th century. The first tetanus vaccine followed soon after, in the early 1920’s. It became more widely used during World War II.

“I myself suffered a fairly severe and deep cut on my ankle from a freak accident a few years ago but the thought of getting a tetanus shot for the injury never even crossed my mind.  I simply soaked my foot and ankle in warm salt water a couple of times a day for about a week to ensure that it stayed clean and contamination free.

The injury healed up nicely and I never exposed myself to the toxins and lingering health problems that can and do result from a tetanus shot.”

The Healthy Home Economist

Of course, when anti-vaccine folks talk about ‘non-toxic’ ways, they mean holistic type treatments without vaccines or other standard medical treatments.

When they tell you to clean the wound and take “extra cod liver oil, natural vitamin C, lacto-fermented foods and plenty of bone broths,” they are basically saying to hope that you are lucky and you don’t get tetanus.

Not only is the tetanus vaccine not toxic, but it helps fight the toxin that tetanus bacteria could produce in a contaminated wound.

What about hydrogen peroxide or colloidal silver? Like simple cleaning, with a deep puncture wound, none of those things will likely get to the ‘bottom’ of the wound. If you have even seen a puncture wound, like when a child steps on a nail, there is not much to clean. The wound typically closes up as the nail or other object exits the skin. Even with other wounds, unless you surgically open and irrigate the wound, you likely won’t clean it well enough to get all of the spores out if they are there.

What to Know About Tetanus and Tetanus Shots

Keeping up-to-date on your tetanus vaccines, which might mean an early shot if you have a dirty wound, is the only way to avoid serious and potentially life-threatening tetanus infections.

More About Tetanus and Tetanus Shots

Who Is at Risk If You Don’t Vaccinate Your Kids?

Passive immunity doesn't last until 12 months, when infants get their first dose of the MMR vaccine, so they are at risk for disease.
Passive immunity doesn’t last until 12 months, when infants get their first dose of the MMR vaccine, so they are at risk for disease. Photo by Jamie Beverly (CC BY-SA 2.0)

Whenever there is a discussion about folks who intentionally choose to not vaccinate themselves or their kids, one of their arguments invariably is ‘why are you so worried if you and your kids are vaccinated?”

Here is an example:

“My argument is simple. If you are vaccinated, you should not have to fear an outbreak of any preventable disease. That’s what the vaccine is supposed to prevent, right? Therefore, why should anyone butt into someone else’s business and tell them they should vaccinate? If one and one’s dependents are vaccinated, why should they have to worry about my personal decision to not vaccinate?”

I personally don’t believe in vaccines

As most people understand, the argument is far from simple.

Who Is at Risk If You Don’t Vaccinate Your Kids?

There are many people who are at risk from those who are unvaccinated, including those who:

  • are too young to be vaccinated or fully vaccinated – remember, with the latest immunization schedule, kids don’t typically get their first MMR until age 12 months and their second until they are 4 to 6 years old
  • can’t be fully vaccinated and have a true medical exemption – this includes children and adults with some immune system problems, vaccine allergies, or other contraindications to getting one or more vaccines
  • were vaccinated, but later developed an immune system problem and their immunity has worn off – might include children with cancer, AIDS, those receiving immunosuppressive therapy after a transplant, or a condition that requires immunosuppressive doses of steroids, etc.
  • were vaccinated, but their vaccine didn’t work or has begun to wear off (waning immunity) – vaccines work well, but no vaccine is 100% effective

These are the children and adults that can be, and should be, protected by herd immunity. At least they can be when most folks are vaccinated.

“We want to create a ‘protective cocoon’ of immunized persons surrounding patients with primary immunodeficiency diseases so that they have less chance of being exposed to a potentially serious infection like influenza.”

Medical Advisory Committee of the Immune Deficiency Foundation

So while some folks who are against vaccines try to scare others about shedding, those who take care of kids with immune system problems and their families go out of the way to get everyone around them vaccinated so their kids aren’t at risk of getting a vaccine-preventable disease!

“…the increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children.”

Medical Advisory Committee of the Immune Deficiency Foundation

Tragically, not everyone has gotten the message, and we continue to see and hear about kids who are too young to be vaccinated or who couldn’t be vaccinated get exposed to those who got sick because they simply chose to not get vaccinated.

What to Know About Risks from the Unvaccinated

Intentionally unvaccinated children and adults put others at risk for vaccine-preventable diseases.

More Information on Risks from the Unvaccinated

Effectiveness Rates of Vaccines

We know that vaccines work.

But how well do they work?

Taken together, you have to say that vaccines work very well.

Remember, according to the CDC:

Vaccine efficacy/effectiveness (VE) is measured by calculating the risk of disease among vaccinated and unvaccinated persons and determining the percentage reduction in risk of disease among vaccinated persons relative to unvaccinated persons. The greater the percentage reduction of illness in the vaccinated group, the greater the vaccine efficacy/effectiveness.

They aren’t perfect though and some vaccines do work better than others.

For example, the MMR vaccine provides 99% protection (two doses) against measles, while the seasonal flu vaccine can vary from 10% to 60%, depending  on how well the flu vaccine matches the flu virus strains that are getting people sick that year.

Fortunately, most vaccines have over 90 to 95% effectiveness.

The exceptions, in addition to flu vaccines, are the mumps and pertussis vaccines.

In addition to problems with waning immunity, they have lower rates of effectiveness than most other vaccines:

That’s probably why we are seeing more outbreaks of mumps and pertussis among vaccinated children and young adults, although intentionally unvaccinated children and adults are also contributing to most of those outbreaks.

For More Information On Efficacy Rates of Vaccines:

Herd Immunity

Herd immunity or community immunity refers to the process in which all people are protected against a vaccine-preventable disease because most of the community is vaccinated.

For more information: