By Dr. Jeff Daniels EBS Medical Columnist
Why should every adult make sure they’re up to date on their tetanus shots? Hint: It’s not only to prevent tetanus!
Tetanus is a disease that has been with us for a long time and used to strike the general population sporadically, like rabies or polio. Tetanus is not contagious, but develops when the bacteria Clostridium tetani enters the body and causes an infection in an area it can thrive in: namely, where there isn’t a lot of blood flow and oxygen. That’s because C. tetani is an anaerobic bacterium, meaning oxygen will kill it.
So, if you’re punctured deep in a part of the body with dense tissue and limited blood flow—a prime example is stepping on a nail—you have the potential to allow this bacterium to cause an infection. Not only does the bacteria lurk in the dirt, it can be found on the skin, so any cut on the body has the potential to cause tetanus.
The growth of that bacteria does not spread through the body like other bad bacterial infections; the C. tetani that are able to grow release a poison into the body, called tetanus toxoid, which causes all the muscles to go into a severe irreversible spasm. That’s how it can kill you.
A vaccine to effectively block the tetanus toxoid was developed many years ago, and is administered to children two to six months old, then at 5 years old, and approximately every 10 years thereafter.
It’s a wonderful vaccine—I’ve given about 10,000 tetanus shots in my career, and I’ve yet to see one case of tetanus. That’s right, not a single case.
So why do I recommend that every adult get the “new” tetanus vaccine, referred to as “Tdap”? Because you not only get a vaccination against the tetanus toxoid, as well as diphtheria—another scourge that has been removed because of vaccinations—but you will also receive a booster for whooping cough. That’s the “ap” part of Tdap.
Whooping cough, caused by Bordatella pertussis, is a nasty bacterial infection that can be fatal in infants, although rarely in adults. The vaccine was developed against this disease in the early 1960s; prior to that, most of us over 60 years old caught it as a childhood illness, along with chicken pox, mumps, measles, and German measles—all illnesses that are now preventable by vaccinations.
It seemed that the pertussis vaccinations, which were only given up to age 5 since the early ‘60s, had eliminated whooping cough. However, in the early 2000s more and more cases of whooping cough were being diagnosed—even here in the Big Sky School District—so the Centers for Disease Control and Prevention recommends that teenagers and adults get vaccinated (or revaccinated) for this disease.
The only way to get vaccinated against pertussis is by getting the Tdap vaccine—it is not sold separately. Since I’ve seen or diagnosed about a dozen cases of whooping cough, I know that administering this vaccine will definitely prevent some of us from experiencing a miserable illness. It also helps protect newborns, which are dangerously susceptible to pertussis.
We’re not sure yet how many pertussis “boosters” will be necessary over our lifetime to keep us pertussis free, but data has been collected since Tdap was introduced around 2009.
To me, a Tdap every 10 years seems very reasonable.
Dr. Jeff Daniels was the recipient of the 2016 Big Sky Chamber of Commerce Chet Huntley Lifetime Achievement Award and has been practicing medicine in Big Sky since 1994, when he and his family moved here from New York City. A unique program he implements has attracted more than 700 medical students and young doctors to train with the Medical Clinic of Big Sky.