Monday, November 4, 2013

When was Your Last Tetanus Shot?

Since it's time for everyone's annual FLU VACCINE, I thought I'd take a few posts and reflect on a couple other vaccines. Today, let's talk about the TETANUS vaccine.

What does the tetanus vaccine do? Most people have heard that if you "step on a rusty nail", you should make sure you are up to date on your tetanus booster. Actually, this should be true for any significant breaks in the skin such as burns, puncture wounds or "road rash".  The tetanus vaccine boosts our immunity to the bacteria called Clostridium tetani, an organism that lives all around us, but especially in the soil, dust and any areas that my be in contact with manure or saliva.

What is tetanus (the disease)? Tetanus used to be called "lock jaw", and even Hippocrates knew about this disease nearly 30 centuries ago! This disease causes intense spasms of skeletal muscles, especially the neck and jaw muscles (making it impossible to open your mouth or to swallow). The infection can be very severe, and has a high mortality rate in children (1 in 5 cases.) We rarely see this disease in the United States now, thanks to routine vaccinations, but it still occurs in roughly one million people each year around the world.

The tetanus vaccine is the "T" in the DTaP series (Diptheria, Tetanus and acellular Pertussis.) All children should receive 5 routine doses- 2, 4, 6, 12-15 months, and 4-6 years. The next recommended booster comes at 11-12 years (or up to age 18) and is a slightly different preparation, the Tdap. The Tdap is still Tetanus, diptheria and pertussis, but the diptheria and pertussis (marked by the lower case letters) are reduced strength boosters since adolescents and adults no longer require the full strength childhood versions.

New changes in Tdap recommendations are the result of recent pertussis outbreaks in the United States, and include routine vaccination for all adults ages 19 and older with a single booster of Tdap (unless the individual received Tdap as an adolescent), as well as every pregnant women in her third trimester (for each and every pregnancy).

To clarify, after the basic 5 childhood immunizations of DTaP, an adolescent should receive one Tdap (the booster vaccine) between the ages of 11-18, then simply the Td (Tetanus/diptheria) booster every ten years. All adults who have only received the Td booster should receive one dose of Tdap now, regardless of how long it has been since their last Td shot.

BOTTOM LINE: Talk with your family doctor and check to see if your immunizations are up to date!

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