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Tetanus is a wretched disease. Toxins released by a nasty bacterium afflict the nervous system, causing muscle spasms so severe they can break bones.
But tetanus, also known as lockjaw, is avoidable, thanks to a supremely effective vaccine. In the U.S., the protocol is to get a booster every 10 years. But scientists at Oregon Health & Science University say that might be overkill.
The U.S. could stop adult boosters for both tetanus and diphtheria, which are given together, saving the strapped U.S. health care system about $1 billion a year, says Mark Slifka, a professor of microbiology and immunology in the OHSU School of Medicine and lead author of a paper published yesterday in Clinical Microbiology Reviews.
Slifka isn’t a vaccine skeptic. He and his colleagues used scientific methods to show that the vaccines for tetanus and diphtheria, usually given together, confer immunity for 30 years, “well beyond the current recommendation of every 10 years for adults from the U.S. Centers for Disease Control and Prevention,” OHSU said in a release about the paper.
The recommendation comes at a delicate time in vaccine land. Robert F. Kennedy Jr., secretary of the Health and Human Services Department, has expressed skepticism about vaccines, saying that measles can be treated with cod liver oil. Under his guidance, HHS stopped recommending the COVID vaccine for both children and healthy pregnant women.
Former OHSU resident and health author Casey Means has also expressed skepticism about vaccines. She is President Donald Trump’s nominee for U.S. surgeon general.
Cutting back on boosters might sound like more vaccine skepticism. As recently as 1948, tetanus, also known as lockjaw, killed 91% of its victims. The mortality rate for diphtheria was about 50%. Diphtheria still kills 1 in 10 people who aren’t vaccinated.
But now, death from the diseases is almost unknown.
“Thanks to childhood vaccinations, these diseases are incredibly rare,” Slifka said in the release. “In fact, you’re 10 to 1,000 times more likely to be struck by lightning than to be diagnosed with tetanus and diphtheria in the United States.”
Among the evidence for discontinuing boosters in adulthood, OHSU says, is a comparison between the United Kingdom and France. Like the U.S., France recommends boosters for adults. By contrast, the U.K. has since the 1950s recommended stopping tetanus and diphtheria shots at age 14.
“This represents sort of an experiment of nature,” Slifka says. “We have one country with over 60 million people that for decades has continued to vaccinate adults throughout their lifetime and another nearby country that also has over 60 million people, but over the past 50 years, they have never recommended adult booster vaccinations.”
Despite decades of adult booster vaccination, the review found that France had “virtually no advantage over the U.K. in the rates of tetanus or diphtheria,” OHSU said. “In fact, the review found that the UK had a slightly lower rate overall.”
Slifka is also a professor at the Oregon National Primate Research Center, the 200-acre facility in Hillsboro that’s home to 5,000 macaques and other monkeys. The center faces cutbacks in funding from the National Institutes of Health by the Trump administration, which is curbing primate research at the Food and Drug Administration and other agencies.
