Immunizations

Tetanus

Tetanus is a severe, often fatal disease. The bacteria that cause tetanus are widely distributed in soil and street dust, are found in the waste of many animals, and are very resistant to heat and germ-killing cleaners. From 1922-1926, there were an estimated 1,314 cases of tetanus per year in the U.S. In the late 1940s, the tetanus vaccine was introduced, and tetanus became a disease that was officially counted and tracked by public health officials. In 2000, only 41 cases of tetanus were reported in the U.S.

People who get tetanus suffer from stiffness and spasms of the muscles. The larynx (throat) can close causing breathing and eating difficulties, muscles spasms can cause fractures (breaks) of the spine and long bones, and some people go into a coma, and die. Approximately 30 percent of reported cases end in death.

Worldwide, tetanus in newborn infants continues to be a huge problem. Every year tetanus kills 300,000 newborns and 30,000 birth mothers who were not properly vaccinated.

Tetanus in the U.S. is primarily a disease of adults. From 1995-1997, 33 percent of reported cases of tetanus occurred among persons 60 years of age or older and 60 percent occurred in patients greater than 40 years of age. The National Health Interview Survey found that in 1995, only 36 percent of adults 65 or older had received a tetanus vaccination during the preceding 10 years.

Even though the number of reported cases is low, an increased number of tetanus cases in younger persons has been observed recently in the U.S. among intravenous drug users, particularly heroin users.

Tetanus is infectious, but not contagious, so unlike other vaccine-preventable diseases, immunization by members of the community will not protect others from the disease. Because tetanus bacteria are widespread in the environment, tetanus can only be prevented by immunization. If vaccination against tetanus were stopped, persons of all ages in the U.S. would be susceptible to this serious disease.

Mumps

Before the mumps vaccine was introduced, mumps was a major cause of deafness in children, occurring in approximately 1 in 20,000 reported cases. Mumps is usually a mild viral disease. However, rare conditions such as swelling of the brain, nerves and spinal cord can lead to serious side effects such as paralysis, seizures, and fluid in the brain.

Serious side effects of mumps are more common among adults than children. Swelling of the testes is the most common side effect in males past the age of puberty, occurring in up to 20 percent to 50 percent of men who contract mumps. An increase in miscarriages has been found among women who develop mumps during the first trimester of pregnancy.

An estimated 212,000 cases of mumps occurred in the U.S. in 1964. After vaccine licensure in 1967, reports of mumps decreased rapidly. In 1986 and 1987, there was a resurgence of mumps with 12,848 cases reported in 1987. Since 1989, the incidence of mumps has declined, with an estimated 327 cases in 2000. This recent decrease is probably due to the fact that children have received a second dose of mumps vaccine (part of the two-dose schedule for measles, mumps, rubella or MMR) and the eventual development of immunity in those who did not gain protection after the first mumps vaccination.

If we were to stop vaccination against mumps, we could expect the number of cases to climb back to pre-vaccine levels, since mumps is easily spread among unvaccinated persons.

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