Recent cases of tetanus in children emphasise the ongoing importance of complete vaccination and booster shots, as incomplete immunisation leaves vulnerable to serious infection despite the disease’s decline.
A routine summer injury turned into a lesson in how quickly tetanus can still become a concern when vaccination is incomplete. In the scenario described by paediatric infectious disease specialist Kristina A. Bryant, a 12-year-old boy arrives at a paediatric emergency department after cutting his thigh on splintered wood while jumping from a dock into a lake. The wound is cleaned and stitched, but his vaccine record shows only a single tetanus dose in infancy, leaving him vulnerable after a contaminated injury.
The exchange that follows with his mother reflects a common misconception: that tetanus, or lockjaw, is a disease of the past. In fact, tetanus remains a serious infection caused by a toxin from Clostridium tetani, a bacterium whose spores are widespread in soil, dust and animal waste. The toxin can trigger painful muscle spasms, jaw stiffness and breathing problems, and severe cases may require prolonged hospital care. According to the World Health Organisation, tetanus is not spread from person to person and does not confer natural immunity after recovery, which is why vaccination is still essential.
The CDC says tetanus cases in the United States have fallen by more than 95% since the vaccine became part of routine childhood immunisation in the 1940s, but the disease has not disappeared. The agency reported 38 cases in 2025, the highest annual total since 2006, and said nearly all involved people who had not completed the primary vaccine series or kept up with 10-year boosters. The CDC and HHS both stress that protection depends on finishing the initial series and maintaining booster doses throughout life.
That risk is not limited to adults. An April 2026 report in the Morbidity and Mortality Weekly Report described four paediatric cases, including injuries from an electric scooter crash, an animal bone and a horse trampling. None of the children had completed the primary tetanus series, and two families declined tetanus immune globulin and vaccination even after medical teams recommended them. Bryant’s point is that wound care alone is not enough; for contaminated injuries in under-immunised children, vaccine and immune globulin are the standard preventive steps, not antibiotics.
The broader public-health message is straightforward. Tetanus is rare in the United States because vaccination works, not because the organism has vanished. The CDC, Mayo Clinic and Cleveland Clinic all advise keeping routine tetanus, diphtheria and pertussis immunisation up to date, including booster shots every decade, while resources such as the American Academy of Pediatrics’ Red Book and immunisation guidance from public health groups can help clinicians decide when post-exposure treatment is needed.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
