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Q: My child received a vaccination for tetanus in our last visit to the doctor. What is tetanus?

A: Tetanus is a nervous system disorder that has been known to exist since the time of the Greeks and the Egyptians. It is marked with muscular spasms that give it its name lockjaw (trismus). The illness is due to a toxin elaborated by the clostridium tetani organism, which is found in soil and is then manifest in individuals who have wounds that are contaminated by the soil with the organism.

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Contributed Image / Peter Rawlings, M.D.

Tetanus antiserum was developed in 1890 but only gave fleeting benefit; the tetanus toxoid vaccine was developed in 1924. This was in common use during WWII, with great benefit in minimizing the tetanus cases. Tetanus vaccine was combined with diphtheria and pertussis in the late 1940s, with that combination being used from 1948 till 1991. At that time, acellular pertussis was introduced, which has marked decrease in the incidence of side effects. It is still in use today.

After the initial series of shots, we all need boosters every 10 years for a clean wound and probably every five years for a dirty wound. I have never seen tetanus in my years of practice, though I have seen measles and pertussis up close and would prefer never to see them again. I have seen the after-effects of polio, and it can be devastating. (When I was in medical school, they still had the iron lungs out, though not in use.) Vaccines can have side effects, but for the vast majority of us, vaccines have eliminated illnesses that used to ravage the world.

— Peter Rawlings, M.D., CHI Memorial Pediatric Diagnostic Associates; Chattanooga- Hamilton County Medical Society member

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