Tetanus Is Making a Comeback and Falling Vaccination Rates Are to Blame

A Preventable Disease That Still Kills

Tetanus may sound like a disease from another era, but experts are warning that it remains a serious threat. New data from the Centers for Disease Control and Prevention paints a sobering picture: two recent CDC reports found hundreds of tetanus cases and dozens of deaths over 15 years, along with four cases in children in 2024 alone. And the trend is getting worse. In 2024, there were 32 cases nationwide. This year, there have been at least 37 confirmed cases — the most in over a decade.

During the 15-year surveillance period, there were 402 reported cases and 37 deaths. Almost all patients required hospitalization, with roughly two-thirds of those admitted needing intensive care. More than 40% of hospitalized patients underwent mechanical ventilation, and about 1 in 10 of all infected individuals died. These are not statistics from a developing country — they are happening right here in the United States.

What Tetanus Actually Is

Tetanus is caused by a bacterium called Clostridium tetani. The bacteria produce spores that are extremely common in the environment — found in soil, dust, and animal manure. Tetanus occurs when the spores enter the body through an injury. Once inside, the bacteria can produce a potent toxin that attacks the nervous system.

Many kinds of injuries can lead to tetanus. Puncture wounds are a classic example, but lacerations, fractures that break the skin, burns, crush injuries, and even relatively minor cuts can also pose a risk if they are contaminated with dirt or debris. In the recent CDC case series involving infections in four children, injuries included an ankle fracture sustained while riding an electric scooter, a puncture wound, and a foot injury. Common symptoms included back, neck, and jaw pain; muscle spasms and muscle rigidity; and difficulty walking.

Children and the Unvaccinated Are Most at Risk

The CDC report described four cases of tetanus in children across four different states — Idaho, Minnesota, Missouri, and Wisconsin — all occurring in 2024. That handful may not sound like a lot, but pediatric tetanus is extremely rare in the US. Among those four children, none had completed a primary vaccine series, and none received vaccine or tetanus immunoglobulin prophylaxis after their exposure and before illness onset. All patients were hospitalized, with a mean duration of 25 days and a range of 8 to 45 days.

Vaccination rates have declined, worrying experts that more people could become vulnerable to this potentially deadly but preventable infection. In states that provided data back to 2019, more than 75% of counties and jurisdictions across the U.S. have seen downward trends in young children getting the diphtheria-tetanus-pertussis (DTaP) series of shots. A CDC surveillance report found that among people who developed tetanus and whose vaccination history was known, nearly half had never received a tetanus vaccine.

What You Can Do Right Now

Adults should receive a tetanus booster every 10 years. Those who have sustained a severe burn or dirty wound should follow up with a booster after five years, according to the CDC. Pregnant individuals should also receive a Tdap vaccine during each pregnancy to help protect newborns. Children whose parents or caregivers decline vaccination are particularly vulnerable.

Older adults are another important group — the highest rates of tetanus cases and tetanus-related deaths occurred among women age 80 and older, according to the CDC report. Because tetanus isn't spread from person to person, there isn't a herd immunity threshold, but reductions in vaccination rates leave more people vulnerable to the disease. With cases climbing and vaccination rates slipping across most of the country, public health experts say the window to reverse this trend is now — before a largely forgotten disease reminds a new generation just how dangerous it can be.