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Unprotected People Reports: Tetanus

Philosophic Objection to Vaccination as a Risk for Tetanus Among Children Younger Than 15 Years

Click here for a fully-formatted PDF version of this report
The Immunization Action Coalition (IAC) publishes articles about people who have suffered or died from vaccine-preventable diseases and periodically devotes an “IAC Express” issue to such an article. This is the 62nd in our series.
The article was published in “Pediatrics” January 2002; the abstract is reprinted below.
By Elizabeth Fair, MPH, Trudy V. Murphy, MD, Anne Golaz, MD, MPH, and Melinda Wharton, MD, MPH
National Immunization Program, Centers for Disease Control and Prevention, Atlanta
Although safe and effective vaccines are available to protect against tetanus in the United States and vaccination rates are high, cases of tetanus among children continue to occur. The objectives of this article are to describe reported cases of tetanus in children in the United States and to identify the reasons for lack of protection against tetanus.

Methods. We reviewed all cases of tetanus in children less than 15 years of age that were reported to the National Notifiable Diseases Surveillance System from 1992 through 2000. Cases were defined by physician diagnosis. We verified the information in the case reports with state and local health departments.

Results. From 1992 through 2000, 15 cases of tetanus in children less than 15 years of age were reported from 11 states. Twelve cases were in boys. Two cases were in neonates less than 10 days of age; the other 13 cases were in children who ranged in age from 3 to 14 years. The median length of hospitalization was 28 days; 8 children required mechanical ventilation. There were no deaths. Twelve (80%) children were unprotected because of lack of vaccination, including 1 neonate whose mother was not vaccinated. Among all unvaccinated cases, objection to vaccination, either religious or philosophic, was the reported reason for choosing not to vaccinate.

Conclusion. The majority of recent cases of tetanus among children in the United States were in unvaccinated children whose parents objected to vaccination. Parents who choose not to vaccinate their children should be advised of the seriousness of the disease and be informed that tetanus is not preventable by means other than vaccination.

To access a camera-ready (PDF) copy of the complete article from the "Pediatrics" website, go to: http://pediatrics.aappublications.org/cgi/reprint/109/1/e2.pdf

10/31/03 • REPORT #62
Disclaimer: The Immunization Action Coalition (IAC) publishes Unprotected People Reports for the purpose of making them available for our readers' review. We have not verified the content of this report.
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