When I take Willow to the Pediatrician and she gets any kind of shots, the doctor gives us a pamphlet with information on the shots (Likely from the CDC). So, since everyone is all up in arms about the links between vaccinations and things like autism, I thought I'd take an in-depth look at the vaccinations. Next in line is the Tetanus vaccination, which is a combination vaccination along with Diphtheria, and Pertussis. However, I am only going to talk about Tetanus here today.
The United States' Centers for Disease Control and Prevention (CDC) Vaccinations and Immunizations section has a recommended immunization schedule that you can download. They also have a lot of great information for each and every vaccination so this is where I will start in my search for information. Here is their pamphlet on the DTaP Vaccination.
The Tetanus vaccination is given as a combination vaccination along with Diphtheria and Pertussis (DTaP) in five doses. The first is at 2 months of age, the second at 4 months of age, the third at 6 months of age, the fourth at 15-18 months of age, and the final vaccination is given between 4-6 years of age. This vaccination is may be given at the same time as other vaccinations.
First, what exactly is Tetanus? Tetanus is a medical condition that is characterized by a prolonged contraction of skeletal muscle fibres. The primary symptoms are caused by tetanospasmin, a neurotoxin produced by the Gram-positive, obligate anaerobic bacterium Clostridium tetani. Infection generally occurs through wound contamination, and often involves a cut or deep puncture wound. As the infection progresses, muscle spasms in the jaw develop, hence the common name, lockjaw. This is followed by difficulty in swallowing and general muscle stiffness and spasms in other parts of the body. Infection can be prevented by proper immunization and by post-exposure prophylaxis.
Tetanus is a noncommunicable disease—it is not transmitted from one person to another.
Tetanus is often associated with rust, especially rusty nails, but this concept is somewhat misleading. Objects that accumulate rust are often found outdoors, or in places that harbour anaerobic bacteria, but the rust itself does not cause tetanus nor does it contain more C. tetani bacteria. The rough surface of rusty metal merely provides a prime habitat for a C. tetani endospore to reside. An endospore is a non-metabolising survival structure that begins to metabolise and cause infection once in an adequate environment. Because C. tetani is an anaerobic bacterium, it and its endospores will thrive in an environment that lacks oxygen. Hence, stepping on a nail (rusty or not) may result in a tetanus infection, as the low-oxygen (anaerobic) environment of a puncture wound provides the bacteria with an ideal breeding ground.
Tetanus Background/History:
In the United States, the reported mortality due to tetanus has declined at a constant rate since the early 1900s, and documented tetanus incidence has declined since the mid- to late 1940s, when national reporting of tetanus cases began. In 2005, a total of 27 tetanus cases and 2 deaths were reported to the national tetanus surveillance system. Several factors have contributed to the decline in tetanus morbidity and mortality, including the widespread use of tetanus toxoid–containing vaccines since the late 1940s. Other factors include improved wound care management and the use of tetanus immune globulin (TIG) for postexposure prophylaxis in wound treatment and for the treatment of tetanus. In addition, increased rural-to-urban migration with consequent decreased exposure to tetanus spores may also have contributed to the decline in tetanus mortality noted during the first half of the 20th century.
Not all states reported deaths from tetanus until after 1932. The estimated rates shown here are based on the population of the reporting states. National reporting of cases began in 1947. Source: Centers for Disease Control and Prevention.
Tetanus is almost entirely preventable through immunization. Vaccination status was known for 993 (61%) of 1,805 tetanus cases reported from 1972 to 2001.2 In only 113 (11%) was receipt of three or more doses of tetanus toxoid reported, and the remaining patients were either unvaccinated or had received fewer than three doses of tetanus toxoid. Wherever immunization programs are in place, the incidence of tetanus declines and the age distribution of case-patients shifts to reflect underimmunization.1 During the period 2001–2005, a total of 142 cases were reported in the United States: 57 (40%) were in persons aged 60 years or older, 74 (52%) were in persons aged 20–59 years, and 11 (8%) were in persons younger than 20 years, including one case of neonatal tetanus (Figure 2).3–7 During each of these years, coverage among infants and children with at least three doses of DTP/DTaP/diphtheria and tetanus toxoids (DT) was 94% or higher. A review of tetanus in U.S. children under age 15 years from 1992 through 2000 found that 11 of the 13 non-neonatal cases occurred in children who were unvaccinated because of religious or philosophic objections.
Despite the availability of highly effective tetanus toxoid–containing vaccines, tetanus continues to have a substantial health impact in the world. In 2002, the World Health Organization estimated that 180,000 deaths worldwide were attributable to neonatal tetanus.14 Neonatal tetanus elimination was defined in 1993 as less than one case of neonatal tetanus for every 1,000 live births per year in each administrative district of a given country.15 The World Health Organization and its partners (the United Nations Children’s Fund and the United Nations Population Fund) are committed to eliminating maternal and neonatal tetanus.
There are two types of Tetanus, Mild and Severe.
Mild Tetanus
Mild cases of tetanus can be treated with:
Severe tetanus
Severe cases will require admission to intensive care. In addition to the measures listed above for mild tetanus:
Tetanus Prevention. Tetanus can be prevented by vaccination. The CDC recommends that adults receive a booster vaccine every ten years, and standard care practice in many places is to give the booster to any patient with a puncture wound who is uncertain of when he or she was last vaccinated, or if he or she has had fewer than 3 lifetime doses of the vaccine. The booster cannot prevent a potentially fatal case of tetanus from the current wound, however, as it can take up to two weeks for tetanus antibodies to form. In children under the age of seven, the tetanus vaccine is often administered as a combined vaccine, DPT/DTaP vaccine, which also includes vaccines against diphtheria and pertussis. For adults and children over seven, the Td vaccine (tetanus and diphtheria) or Tdap (tetanus, diphtheria, and acellular pertussis) is commonly used.
Now, a little about the DTaP vaccination (since we are talking about childhood vaccination). DTaP combines vaccines against three diseases, Diphtheria, Tetanus and Pertussis into one shot. (The small “a” in the name stands for “acellular,” which means that the pertussis component of the vaccine contains only parts of the pertussis bacterium rather than the whole cell.) The diphtheria and tetanus components of the vaccine are not technically vaccines, but “toxoids.” In other words, they help the immune system develop protection against the toxins produced by the diseases rather than against the disease bacteria themselves. All three components of DTaP are “inactivated” (killed). Tetanus, diphtheria and pertussis (DTP) vaccines have been in common use since the 1940s. DTaP vaccine (with the acellular pertussis component) was first licensed in 1991.
Risks of DTaP vaccination - Getting diphtheria, tetanus, or pertussis disease is much riskier than getting DTaP vaccine. However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of DTaP vaccine causing serious harm, or death, is extremely small.
Mild Problems (Common)
These problems occur more often after the 4th and 5th doses of the DTaP series than after earlier doses. Sometimes the 4th or 5th dose of DTaP vaccine is followed by swelling of the entire arm or leg in which the shot was given, lasting 1-7 days (up to about 1 child in 30).
Other mild problems include:
These problems generally occur 1-3 days after the shot.
Moderate Problems (Uncommon)
Severe Problems (Very Rare)
Several other severe problems have been reported after DTaP vaccine. These include:
These are so rare it is hard to tell if they are caused by the vaccine.
Some children should not get the vaccine or should wait to get it. They include:
Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine.
Talk with your doctor if your child:
I found an awesome website that lists the package inserts and ingredients for all available vaccinations (e.g. provided by MERK or GlaxoSmithKline). It's called the World Association for Vaccine Education. You can find their page on DTaP here.
Since we always hear about the link between getting vaccinated and some other disease or condition, I did a search to see if there were links between the DTaP vaccination and any kind of disease or neurological disorder and I couldn't find anything that wasn't mentioned in the vaccination information pamphlet.
More Information:
And since there are those people that are concerned about links of vaccinations to neurological disorders and the like I thought I'd include some of their links as well:
Generation Rescue is an international movement of scientists, physicians and parent-volunteers researching the causes and treatments for autism and mentoring thousands of families in recovering their children from autism.
The Thinktwice Global Vaccine Institute was established in 1996 to provide parents and other concerned people with educational resources enabling them to make more informed vaccine decisions. Thinktwice encourages an uncensored exchange of vaccine information, and supports every family's right to accept or reject vaccines. Thinktwice's DTaP page.
I asked my pediatrician if she had a lot of parents who were choosing to NOT vaccinate their children. She said she could count on one hand the total number and that she, of course, recommends AGAINST not vaccinating your children.
Previously:
Hepatitis B Vaccination Information
Rotavirus Vaccination Information
Diphtheria Vaccination Information
Coming Next Week: Pertussis Vaccination
October 22, 2008
About Vaccination - Tetanus
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