Tetanus – also known as “lockjaw” – can be a painful and fatal disease.

In light of those facts, the invention of a tetanus vaccine, in the years between World Wars I and II, has saved many lives by making people immune to this disease.

Nowadays, nearly all kids are immunized against tetanus. The vaccine is thought to wear off, so the medical establishment recommends that adults get a tetanus shot every ten years.

However, researchers are questioning the wisdom of getting a tetanus shot every decade of your life.

Just for the record, I haven’t had a tetanus shot in nearly forty years, because the disease is so rare I don’t see the point in worrying about it. I don’t waste much time worrying about one-in-a-million risks.

The disease is not contagious – you don’t catch it from other people. You basically get it from dirt entering a wound.

I have an idea: Why not just wash all wounds carefully and put on a disinfectant?

It looks like some scientists, at least, are now coming around to my point of view, and they’ve got the evidence. . .

Tetanus is an infection caused by the strain of bacteria known as Clostridium tetani. If you hurt yourself and cut your skin or get a scrape or puncture wound, the bacteria can enter your body.

Rusty nails have long been reputed to be sources of tetanus, although it’s dirt on the nail — not the rust — that may contain the harmful microbes. My mother used to obsess about stepping on nails, but in fact, working in your garden with an open wound on your hand poses a higher risk, because manure is a prime vector for tetanus germs.

Once the bacteria penetrate the skin’s outer barrier, they can grow and begin to manufacture a toxin that attacks nerve tissue. The effects of this toxin include cramps, muscle spasms and, potentially, seizures.

Its effect on the jaw muscles gives the disease its traditional name – “lockjaw.” But muscles in your stomach, your arms and legs, your chest and throat can also go into spasm. And that’s where the toxin’s risk can become serious – if it freezes your ability to breathe, you can suffocate.

A tetanus vaccination stimulates the immune system to produce antibodies against tetanus. The result: if the bacteria Clostridium tetani gets into the body, immune cells destroy it before it can cause harm.

But do you need a booster vaccination every ten years? Highly doubtful.

“We have always been told to get a tetanus shot every 10 years, but actually, there is very little data to prove or disprove that timeline,” says researcher Mark K. Slifka, who teaches at Oregon Health and Science University. “When we looked at the levels of immunity among 546 adults, we realized that antibody titers (immune defenses) against tetanus and diphtheria lasted much longer than previously believed.”

Dr. Slifka’s research has extensively analyzed how the human body develops and retains immunity to tetanus and diphtheria after somebody is vaccinated. (Diphtheria and tetanus vaccinations are often included in the same shot.)1

His research shows you stay completely protected against tetanus and diphtheria for at least 30 years after you’ve had your tetanus shots – which consists these days of a standard five-dose childhood vaccination series. So he argues we should have a simple vaccination plan. After your childhood shots, get a vaccination at age 30 and then another one at 60.

According to Dr Slifka, “If you ask around, you often find that it is hard for people to remember if they had their last tetanus shot eight years ago or even 11 years ago. If we were to use a simple age-based system, people would only have to remember to get their shots when they turn 30 and again when they turn 60.”

Personally, I don’t feel even that much coverage is necessary.

Other Authorities Agree: Fewer Tetanus Shots

Meanwhile some other countries, such as the United Kingdom, don’t even recommend that any adult needs booster shots. And the World Health Organization recommends only a single adult booster vaccination that should occur if you get pregnant or you’re serving in the military.

Those recommendations are closer to my point of view.

Consider, for instance, what are the chances you will ever get a serious case of tetanus? There are 30 to 50 cases of tetanus in the U.S. each year, most of them not fatal.

“The odds of dying from tetanus in the US are approximately one in 100 million,” says Dr. Slifka. As for diphtheria, he points out, “There have been only five cases of diphtheria reported in the US in the last 15 years. Believe it or not, there are actually more cases of anthrax reported each year than diphtheria.”

To understand those odds, consider that your lifetime chances of dying in a car crash are 1 in 103 and dying from choking on food are around 1 in 3,000.2

To be fair, most Americans are vaccinated, so naturally there are going to be very few tetanus cases, assuming the vaccine lasts for 30 years or more. In the early 1900s, before the vaccine, there were around 2.5 tetanus fatalities per 100,000 people.

If that were the case today, the United States would have more than 7,500 deaths per year in the absence of a vaccine. That is still not a huge risk, in my opinion, but others may feel differently.

Another fact to keep in mind – tetanus was much more of a threat when more people worked at farming or had other professions that meant spending much of their times outdoors exposed to dirt – not to mention manure — that could convey tetanus.

Nowadays most of us are indoors for much of the day and rarely suffer dirty cuts and scrapes on a regular basis. The threat of tetanus is minimal. Sure, get a tetanus booster if you really want to. But is it really necessary? Not for me. I feel good about my odds.


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105026/
  2. https://injuryfacts.nsc.org/ all-injuries/preventable-death-overview/odds-of-dying/