Tetanus Cases on the Rise in the U.S.

Tetanus may not cross your mind very often, but thanks to vaccines, it’s largely preventable. In fact, since 2010, the average number of annual tetanus cases in the United States has been fewer than 40, as reported by the CDC. Most of these cases have involved individuals who either skipped the vaccine or didn’t finish their vaccination schedule.

However, there’s been a notable increase in tetanus cases recently, which is addressed in a new viewpoint article from JAMA. The findings indicate a worrying trend regarding tetanus occurrences in the U.S.

A reminder: Tetanus isn’t something to take lightly. “It’s extremely painful and, without swift treatment, it can be fatal,” notes Jon Andrus, MD, a professor at the George Washington University’s Milken Institute School of Public Health.

So, what’s causing this uptick? And more importantly, how can you protect yourself? Here’s what medical experts have to say.

What is Tetanus?

Tetanus is a bacterial infection caused by Clostridium tetani, as the CDC explains. This bacterium is commonly found in soil, manure, and rusty surfaces.

“It’s naturally occurring in our environment,” says Kathryn Edwards, MD, a leading researcher on vaccines at Vanderbilt University. If you have a cut or scrape, and the bacteria enters through that injury, it can produce a toxin that leads to illness, Dr. Edwards elaborates.

Signs and Symptoms of Tetanus

Symptoms typically start to appear between three and 21 days after exposure, according to the CDC. They might include:

• Jaw muscle spasms, also known as “lockjaw.”
• Sudden, involuntary muscle contractions, often in the stomach area.
• Painful muscle stiffness throughout the body.
• Changes in heart rate and blood pressure.

This illness can escalate to serious complications, including severe tightening of the vocal cords, broken bones, and respiratory issues. In the U.S., about one in ten tetanus cases can be fatal, as per CDC data.

Recovery can also take a while. “Many patients might need ventilation support, and the recovery period can be prolonged as the tetanus toxin affects nerve endings,” says Dr. Edwards.

Current Situation with Tetanus Cases

Just to clarify, while there’s not an outright outbreak of tetanus currently, the increase in cases is significant enough to attract the attention of health officials. In 2023, there were 18 reported cases, and this number rose to 33 in 2025, the latest year for which data is available.

For perspective, the CDC’s statistics show a drop of over 95% in tetanus cases since vaccines became a standard part of childhood immunizations in 1947. So, any increase is certainly concerning.

Moreover, the rise in cases is particularly noted among unvaccinated children, reflecting a concerning shift in attitudes towards vaccination. “We’re noticing a growing reluctance to get the tetanus vaccine,” Dr. Edwards points out. Recently, the CDC reported four instances of tetanus in children who were unvaccinated; they were brought to the emergency room by parents who opted against getting them vaccinated.

For an illness that can be entirely prevented—and is obviously dangerous—this trend poses unsettling questions for public health. “There’s a real concern that parents may think their children don’t need certain vaccines due to the general hesitancy around vaccinations,” Dr. Edwards warns. The resurgence of other conditions like measles, which has also seen increases partly due to vaccine hesitancy, highlights this issue.

How to Prevent Tetanus

The best way to prevent tetanus is through vaccination. “Staying up-to-date with vaccines is crucial,” states John Sellick, DO, an expert in infectious diseases at the University at Buffalo. This involves adhering to the recommended vaccination schedule and receiving booster shots if you suffer a significant injury.

Even though cases are rare, the bacteria remains a threat, and it’s important to vaccinate ourselves and our children against diseases that could reemerge if we’re not vigilant. “We need to ensure ongoing protection against these historical diseases,” emphasizes Dr. Andrus.