Tetanus Cases Rise in the U.S. Amid Declining Vaccination Rates, CDC Reports Show
核心洞察
CDC (搜索) surveillance data from 2009–2023 documented 402 tetanus (搜索) cases and 37 deaths, with nearly half of patients having never received a tetanus vaccine.
Four pediatric tetanus (搜索) cases occurred in 2024 alone, matching the typical annual national total, all in children who had not completed the primary vaccination series.
U.S. tetanus (搜索) cases rose from 18 in 2023 to 33 in 2025, prompting public health experts to warn about growing vaccine hesitancy.
Two recent reports from the U.S. Centers for Disease Control and Prevention are renewing attention on tetanus (搜索), a potentially fatal but entirely vaccine-preventable disease that public health experts say is making a concerning comeback. A CDC (搜索) surveillance summary covering 2009 through 2023 documented 402 reported cases and 37 deaths across the United States, while a separate report identified four pediatric cases in 2024 alone — a number that matches the typical annual national total for children.
The resurgence has continued: CDC (搜索) data show 18 reported cases in 2023, rising to 33 in 2025, the most recent year for which data are available. While tetanus (搜索) cases have declined by over 95 percent since the vaccine became a standard part of U.S. childhood immunizations in 1947, any uptick is enough to raise alarm among public health officials.
A Disease That Never Left the Environment
Tetanus (搜索) is caused by the bacterium Clostridium tetani, whose spores are ubiquitous in soil, dust, and animal manure. Infection occurs when spores enter the body through a break in the skin — puncture wounds, lacerations, fractures that break the skin, burns, crush injuries, and even relatively minor cuts can all pose a risk if contaminated with dirt or debris.
"Tetanus (搜索) is no joke. It's very painful and, if it's not rapidly treated, it can be deadly," said Dr. Jon Andrus, professor of Global Health at the George Washington University Milken Institute School of Public Health.
Once inside the body, the bacteria produce a potent neurotoxin that attacks the nervous system. Symptoms typically begin several days to weeks after injury and classically include lockjaw — jaw muscle spasms — along with neck pain, back pain, difficulty swallowing, and painful muscle stiffness throughout the body. As the disease progresses, muscles involved in breathing may stop functioning, and patients can develop dangerous fluctuations in blood pressure and abnormal heart rhythms.
"It is in the ground and will always be around," said Dr. Kathryn Edwards, lead author of a JAMA viewpoint article on the resurgence, vaccinology researcher, and professor of pediatrics at Vanderbilt University Medical Center. "Often patients have to be on ventilators and they're convalescent for a long time because tetanus (搜索) binds to the nerve endings and stays there."
The Toll on Patients
The CDC (搜索) surveillance summary revealed that almost all patients required hospitalization, with roughly two-thirds of those admitted needing intensive care. More than 40 percent of hospitalized patients underwent mechanical ventilation, and approximately one in 10 of all infected individuals died.
The highest rates of tetanus (搜索) cases and tetanus-related deaths occurred among women aged 80 and older. The primary series of the tetanus vaccine was first recommended in 1947, and it is possible that some older women never received the primary series, nor did they receive vaccination through military service as men of similar ages did.
Pediatric Cases Raise Alarm
The four pediatric cases reported in 2024 occurred across four states — Idaho, Minnesota, Missouri, and Wisconsin. All four children developed generalized tetanus (搜索), the most common and severe form of the disease, in which the toxin affects muscles throughout the body rather than remaining confined to one area. Each patient required hospitalization, with stays ranging from eight to 45 days.
Critically, none of the children had completed the primary tetanus (搜索) vaccination series. In two of the cases, families sought medical care after the injury but declined the recommended preventive treatment, including a tetanus-containing vaccine and tetanus immune globulin.
"We're seeing that there is more of a pushback against the tetanus vaccine," Dr. Edwards said. "The recent CDC (搜索) report included four cases of tetanus (搜索) in children who had not been vaccinated; they went to the ER and parents said they didn't want a tetanus vaccine, and tetanus developed."
Vaccination: The Only Reliable Protection
Unlike measles and other contagious diseases, tetanus (搜索) does not spread from person to person. This means herd immunity offers no protection — individuals cannot rely on others around them being vaccinated to stay safe.
The American Academy of Pediatrics recommends that children receive five doses of a tetanus (搜索)-containing vaccine as part of the routine childhood immunization schedule, beginning at 2 months of age. Adolescents should receive a Tdap (搜索) booster at age 11 or 12, and adults should receive a tetanus booster every 10 years thereafter. Pregnant individuals are advised to receive a Tdap vaccine during each pregnancy to help protect newborns against neonatal tetanus.
Among people who developed tetanus (搜索) and whose vaccination history was known, the CDC (搜索) found that nearly half had never received a tetanus vaccine.
"We're becoming concerned that people are going to say that their children may not need to be vaccinated because of hesitancy about vaccines in general," Dr. Edwards said.
Dr. Andrus offered a blunt warning: "We have to vaccinate our children and ourselves against these old diseases or they will come back."
What to Do After an Injury
Experts emphasize that people should seek prompt medical attention for deep puncture wounds, wounds contaminated with dirt or animal feces, crush injuries, burns, frostbite injuries, or any wound containing debris that cannot easily be cleaned. A clinician can determine whether additional tetanus (搜索) protection — including a tetanus-containing vaccine or tetanus immune globulin — is warranted.
"Vaccination is really key with this," said Dr. John Sellick, an infectious disease expert and professor of medicine at the University at Buffalo/SUNY. The bacteria that cause tetanus (搜索), he and other experts stress, are everywhere in the environment and cannot be eliminated — making staying up to date on vaccination the only reliable defense against a disease that remains as dangerous as ever.