tetanus questions

[chelsmm]

My kids have their annual pedi appt tomorrow. Our pedi mentions vaccines each time, but he doesn't push. He does strongly encourage tetanus.

So, yearly I think about it My kids are both without any vaccines. I don't want to start now.

I just read that in 3 out of every 10 tetanus cases in the US the person dies. That seems high to me. I know there are only about 50-100 cases a year, and I know there's a cure, if it's caught in time. I'd love to hear the details about those who contracted it, but I'm pretty sure that's not available.

I know that tetanus spores can be found all over outside. I have read that they are anerobic, so a bleeding cut can't harbor tetanus.

Anyways, I'm looking for thoughts on tetanus specifically with these stats in mind.

http://www.dhpe.org/infect/tetanus.html

This is where I read the 3/10 thing.

Thanks, Chelsea.

FWIW, my kids are 3 and 5. They are outside a lot. They are barefoot a lot.

[~Adorkable~]

Hmm with all the barefoot hyjinx I got into as a kid, that was probably the best vax I ever got.
And in reference to being caught early? In guessing what this means in practice is that the first moment they get scrapped my something unknown, they will need to get the shot, and with kids this might happen pretty fast. I may be wrong, but I don't think you can wait for symptoms to appear before treating. I may be wrong

In the end it seems like they would end up with it eventually, probably soon than later if they wander barefoot like I did.
Might as well get this one now and spare the stress later. That just my free advice, worth every penny!

[poppan]

The average number of cases has been (to my knowledge) pretty steady at around 42-45 cases per year in the US. Death rate is 10-20% with the deaths occurring in people over age 60 or with weakened immune systems to start. Of the reports I have read, all the children recovered.

Sources:
MMWR Tetanus Surveillance Report 1998-2000:
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5203a1.htm
MMWR Tetanus Surveillance Report 1995-1997:
http://www.cdc.gov/mmwr/preview/mmwrhtml/00053713.htm

[terra-pip]

I have the philosophy that if you're careful and safety minded. Maybe insist on shoes or at least shoes when playing outside other than your own yard. And making sure that your yard is free of dangerous material or animal feces etc. Just basic common sense sort of stuff. Keeping tools and nails and anything of that sort well put away and taken care of...not letting things rust etc would help a lot. Keeping a good eye out for hazards when in public etc. And if something were to happen that seemed to require a tetanus then get one. Doesn't it last for 10 years anyway? I cut myself when I fell in a movie theater and got a tetanus shot when I went to the ER to get stitches and I agreed because I was thinking "well it's a public place and an older theater. I'm not up to date, no big deal." You have to ask yourself what kind of injury a non crawling, non walking baby is going to susutain to require a tetanus?

[chelsmm]

Except that my kids are walking. I do have them wear shoes in public, but if we are at a beach or pond, shoes will be off. In our yard, shoes are off.

poppan- do you think the rate is low for kids because they are vaccinated? Older adults are probably not up on boosters, right?

No deaths occurred among those who were up-to-date with tetanus toxoid vaccination-- from the first link that you provided.

[ammiga]

This study published by the AAP found 15 cases of tetanus in people under 15 from 1992-2000. Tetanus is extremely rare in general, but especially in people healthy circulatory systems. The reason that the disease is more rampant in the elderly is because their circulatory systems are worse off and they have a higher rate of diabetes than children.

Unless your children suffer from diabetes or other diseases that affect circulation, they should be fine.

Just remember, every pediatrician has a pet vaccine, and it varies from doctor to doctor. It sounds like your doctor's pet vax is DTaP. For some odd reason, my dd's first pedi was obsessed with Rotavirus

[poppan]

Originally Posted by chelsmm

poppan- do you think the rate is low for kids because they are vaccinated? Older adults are probably not up on boosters, right?

No deaths occurred among those who were up-to-date with tetanus toxoid vaccination-- from the first link that you provided.

That has occurred to me--that maybe the vax works and that's why there aren't that many cases in kids, since they are as a group pretty updated on vaxes. Ammiga's link said 12 (80%) of the 15 kids under age 15 who had tetanus were unvax'd (which usually includes the partially vax'd as well). Which still leaves 20% of them fully vax'd -- higher proportion than the vax coverage rate in the population, which suggests to me that the vax has good protection but it's not anywhere close to 100% effective. So I also think that kids are better able to handle tetanus than adults >60, regardless of vaccination status.

Did you look at the regional maps at the end of the report? Tetanus is apparently somewhat regional so if you lived in one of the white-colored states, you may have a lot less to worry about? That would factor into my decision. That and the fact that there really are only a handful of cases a year and your kids don't have risk factors like being an intravenous drug user, a diabetic, or over age 60.

Originally Posted by •Adorkable•

I may be wrong, but I don't think you can wait for symptoms to appear before treating. I may be wrong

It seems like they do administer TIG after onset of symptoms, although I'm not sure I have enough info to draw a conclusion that it worked. Out of the 130 cases in 1998-2000, 125 received TIG. 20 died (18%). It was not detailed in the report whether the 20 received TIG and when they received it, if they did. The report indicated that in 1947, the death rate was 91% (but I have no info on treatment back then or how the reporting was done).

[chelsmm]

I'm in a gray state.

I can't imagine giving my kids a vaccine. The thought of it makes me feel sick. But for some reason, this one worries me.

[zinemama]

Tetanus worried me, too. Unlike most of the other VPDs, this was one where I believed there was a fair chance of death if my kids caught it. So we got it the vax.

[poppan]

I don't envy you your decision. In some ways it was good that my DD had a reaction to DTaP. It made my choices crystal clear.

[chelsmm]

ugh. This is so difficult. I still don't know what to do.

[alegna]

It was years ago when I researched, so I don't have links, but when I researched, tetanus was ALWAYS very rare- even rarer in children.

It's not the vax keeping it low. It's just very difficult to contract.

Public places, etc have nothing to do with tetanus.

-Angela

[popbaby]

We just got back from our appt today...DD1 is 3 1/2...100% vax free...we have an awesome homeopathic doc...she doesn't even do vax's at her practice, but she does recommend Tetnus. She gets the single vax in her office..its the one single one she does...sigh...now here I am, wondering what to do...

[ma2two]

Originally Posted by poppan

I don't envy you your decision. In some ways it was good that my DD had a reaction to DTaP. It made my choices crystal clear.

People's kids shouldn't have to be vaccine injured before they can feel okay about not vaccinating. Your statement really shows how deep the fear runs.

According to the CDC's Pink Book, there are about 30 cases of tetanus per year in the U.S. Most are in people over 40, and a significant percentage are in heroin users. Tetanus is fatal in about 10% of cases. http://www.cdc.gov/vaccines/pubs/pin...ds/tetanus.pdf

In a population of over 300 million, I'm not going to worry about 30 cases of tetanus and 3 deaths. I'd worry a lot more about the car trip to the vaccine clinic or doctor's office. And I'd worry a LOT, LOT more about possible vaccine injury, or any health effects that may not be immediately apparent, or ever tied to the vaccine.

popbaby, I can't imagine a homeopath recommending any allopathic vaccines. Has she at least informed you that there is mercury in the vaccine she carries? Either 0.3 mcg or 25 mcg. Or maybe it is actually a tetanus nosode? That would make more sense.

[popbaby]

ma2two...thank you...I know...I was surprised...she suggested I brush up on my Tetanus research and to think about it...I said I didn't think it was necessary, but for some reason, it has been on my mind all afternoon since we left her office. I was just on the NVIC site, linked to vaccineshoppe, and I don't see any single dose tetanus vax there, except one for ages 7+...she said she gets it from sanofi pasteur...not sure which one she is talking about...

I also just re-read a few chapters in my various books, and I feel better again, reminded that we made the right choice.

[ma2two]

Originally Posted by popbaby

I was just on the NVIC site, linked to vaccineshoppe, and I don't see any single dose tetanus vax there, except one for ages 7+...she said she gets it from sanofi pasteur...not sure which one she is talking about...

Yes, the single tetanus vaccine is only for people 7 years and older.

Here are the package inserts.
http://www.fda.gov/downloads/Biologi.../UCM142732.pdf
http://www.fda.gov/downloads/Biologi.../UCM166873.pdf

[BunnySlippers]

I do not buy into the whole must have tetanus vac thought. It doesnt make any more sense(to me) then the rest of the vaccines. A rabies vaccine would probably come in more handy than a tetanus one. Not that Id go for that.

My barefooted farm-girl stepped on some boards that I had leaning against the horse paddock for de-nailing. Naturally she stepped on a nail I was not home...Grandma washed it (thankfully) put HER prescription steroid cream on it (which I was pretty upset about) then covered it with a bandaid.

I went really? after all of my 'this is what we do if barefoot girl gets a puncture or cut with something rusty' talks, nags, reminders. Gma still does all the wrong things (aside from the initial wash and peroxide).
anyway..point of the story. Barefoot girl is alive and healthy and NO vaccines were involved.

[Emmeline II]

DTaP

It is not the rust that causes tetanus, so a rusty nail in and of itself is not the issue. Tetanus needs an anaerobic environment to thrive. A wound that has bled is not typically that environment. Keep it clean and covered. A Tetanus vax at time of injury is supposed to be a booster to those current on vax and TIG (tetanus immunoglobulin) is for the unvaxed.
In the United States, tetanus is primarily a disease of older adults. Persons greater than or equal to 40 years of age now account for over 70% of reported cases. Tetanus Surveillance 1998-2000 , Power of 10.

"Keep in mind that the tetanus vaccine became available for widespread civilian use in the late 1940's. Thus tetanus mortality had declined from 205 deaths per 100,000 wounds in the American Civil War (1860) to about .4 deaths per 100,000 population in 1947 at the beginning of widespread civilian use of the vaccine. This means that sanitation, nutrition, year around nutritional improvements, general hygiene, and wound hygiene had reduced the mortality and incidence of tetanus by as much as 99.8 percent before the widespread use of tetanus vaccine." Hilary Butler 89wds