That’s the subject of a new JAMA viewpoint article, which found that tetanus cases are increasing in America.
Meet the experts: Kathryn Edwards, MD, is a vaccinology researcher and professor of pediatrics at Vanderbilt University Medical Center.
What’s going on with tetanus cases in the U.S.?
“We're seeing that there is more of a pushback against the tetanus vaccine,” Dr. Edwards says.
How to Prevent TetanusTetanus is preventable by getting the tetanus vaccine.
Tetanus is probably not something you think about a whole lot. That’s because, thanks to the vaccine, infections are largely preventable. And, we’re talking very preventable. Since 2010, there have been less than 40 cases of tetanus in the United States per year, according to the Centers for Disease Control and Prevention (CDC). (A majority of those cases occurred in people who either never got the vaccine or didn’t complete the shot protocol.)
Unfortunately, there’s been a resurgence of tetanus in the U.S. lately. That’s the subject of a new JAMA viewpoint article, which found that tetanus cases are increasing in America.
A reminder: Tetanus is no joke. “It’s very painful and, if it’s not rapidly treated, it can be deadly,” says Jon Andrus, MD, professor of Global Health at the George Washington University Milken Institute School of Public Health.
What’s behind this increase and, more importantly, how can you lower your own risk of tetanus? Here’s what doctors want you to know.
Meet the experts: Kathryn Edwards, MD, is a vaccinology researcher and professor of pediatrics at Vanderbilt University Medical Center. John Sellick, DO, is an infectious disease expert and professor of medicine at the University at Buffalo/SUNY. Jon Andrus, MD, is a professor of Global Health at the George Washington University Milken Institute School of Public Health.
What is tetanus?
Tetanus is a bacterial infection called Clostridium tetani, according to the CDC. It’s found in the environment, most commonly in soil, manure, and rust.
“It is in the ground and will always be around,” says Kathryn Edwards, MD, the lead author of the JAMA report, a vaccinology researcher, and professor of pediatrics at Vanderbilt University Medical Center. From there, if you get an injury to your skin like a cut or scrape and Clostridium tetani gets inside, it can produce a toxin that makes you sick, Dr. Edwards explains.
Signs and Symptoms of Tetanus
Symptoms of tetanus usually show up anywhere from three to 21 days after someone is exposed, according to the CDC. They include:
Spasms of the jaw muscles, or “lockjaw”
Trouble swallowing
Sudden, involuntary muscle spasms, usually in the stomach
Painful muscle stiffness all over the body
Seizures
Headache
Fever and sweating
Changes in blood pressure and heart rate
The illness can then lead to complications, like an uncontrolled tightening of the vocal chords, broken bones, a pulmonary embolism, aspiration pneumonia, or difficulty breathing. In the United States, one in 10 cases of tetanus are fatal, per the CDC.
Recovery can also take some time. “Often patients have to be on ventilators and they're convalescent for a long time because tetanus binds to the nerve endings and stays there,” Dr. Edwards says.
What’s going on with tetanus cases in the U.S.?
To be clear: There isn’t a huge outbreak of tetanus in the U.S. right now, but cases are increasing enough that it’s catching the attention of public health officials. In 2023, there were 18 reported cases of tetanus in the U.S. Then, in 2025, which is the most recent year that data is available, there were 33.
For context, CDC data shows an over 95 percent decrease in tetanus cases since 1947—which is when the vaccine became a standard part of U.S. childhood immunizations—so any uptick is enough to raise a red flag.
Plus, cases are increasing most in children who haven’t been vaccinated, which is part of a larger cultural change across the country. “We're seeing that there is more of a pushback against the tetanus vaccine,” Dr. Edwards says. “The recent CDC report included four cases of tetanus 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.”
For an illness that is largely preventable—and entirely dangerous—it’s an unsettling trend for public health experts. “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 says. (Another illness that has largely been eliminated, measles, has been seeing upticks over recent years also partly due to vaccine hesitancy.)
How to Prevent Tetanus
Tetanus is preventable by getting the tetanus vaccine. “Vaccination is really key with this,” says John Sellick, DO, an infectious disease expert and professor of medicine at the University at Buffalo/SUNY. That means sticking with the recommended vaccine schedule and getting emergency ones if you get a bad cut and your doctor deems it appropriate.
Just because there aren’t a whole lot of cases, doesn’t mean that bacteria itself isn’t still dangerous—or still around. “We have to vaccinate our children and ourselves against these old diseases or they will come back,” Dr. Andrus says.
