Why CDC is Working to Prevent Tetanus Globally

At a glance

Tetanus remains a major public health problem that has significant health and monetary costs – especially for mothers and newborns. Despite the availability of a low-cost, effective vaccine, challenges remain in ensuring vaccination for all.

Under an awning, a woman in glasses and a hairnet leans over another woman, who is holding an infant in her lap, and gives the infant a shot in his leg.

Health Costs

Tetanus causes thousands of deaths a year.‎

High rates of routine immunization across all ages with tetanus vaccines – including booster doses – can prevent tetanus. When these rates are not optimal or not known, vaccination of pregnant women and women of childbearing age is recommended to prevent tetanus among mothers and newborns.

Health costs of maternal and neonatal tetanus

Tetanus among mothers and newborns (known as maternal and neonatal tetanus) remains a major public health problem globally.

Mothers and newborns living in places with low vaccination rates among women of childbearing age are at increased risk of maternal and neonatal tetanus. The risk of maternal and neonatal tetanus is highest among mothers and infants living in areas where women have limited access to clean deliveries and umbilical cord care.

Among infants who get tetanus, 80-100% will die. Eliminating maternal and neonatal tetanus in the countries where it remains a public health problem would prevent an estimated 70,000 deaths over a 10-year period.1

Health costs of tetanus throughout life

A 2020 study of global disease2 estimated that more than 73,000 tetanus cases occurred in 2019. Among the 34,700 people who died from tetanus that year, most were in South Asia and Sub-Saharan Africa.

According to the World Health Organization, rates of tetanus infections and deaths are increasing among adult men.3 This trend is evident in countries that do not provide tetanus boosters for men and boys after they are first vaccinated as infants.

Sub-Saharan Africa has the highest rate of tetanus among people who aren't newborns (non-neonatal tetanus infections). In that region, 71% of hospitalized tetanus patients are men.

Monetary Costs

Under an awning, a woman in glasses and a hairnet leans over another woman, who is holding an infant in her lap, and gives the infant a shot in his leg.
A healthcare worker in Brazil gives an infant a pentavalent vaccine to protect against diphtheria, tetanus, pertussis, hepatitis B, and haemophilus influenzae type b (Hib). ©UNICEF/U.S.CDC/UNI408817/Hiller
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Tetanus costs families and countries millions annually.‎

Tetanus is difficult and expensive to treat but can be prevented by an inexpensive and effective vaccine.

In people who haven't received tetanus vaccines, tetanus infection almost always requires admission to the hospital for treatment.

People being treated for tetanus can be hospitalized for several weeks, leading to high healthcare costs. While limited data is available on the cost of treating tetanus globally, studies in the United States have shown that treating tetanus is extremely expensive.

According to a 2017 case study in the United States, the healthcare cost to treat a single child for tetanus was over $800,000.4

Providing tetanus vaccines – which is the only way people can become immune to tetanus – costs far less than treating tetanus.

Challenges

Many children and pregnant women are not fully vaccinated against tetanus.‎

They are at risk of death from tetanus, or serious health complications that can be lifelong.

As the map below shows, tetanus among mothers and newborns remains a public health problem in 11 countries. In order to eliminate maternal and neonatal tetanus, these countries must prevent the disease among mothers and newborns.

In addition to efforts to eliminate maternal and neonatal tetanus, more work is needed to raise routine immunizationA rates.

In 2020, an estimated 30 million children missed doses of three-dose primary vaccine series for tetanus (DTP3). 5 In addition, several countries still do not provide the tetanus booster shots needed to protect people throughout life.

CDC works with partners and countries to eliminate maternal and neonatal tetanus and promote protection against tetanus throughout life.

Resources

World Health Organization

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Content Source:
Global Immunization
  1. Routine immunization refers to the vaccinations recommended for everyone within a country, depending on age and vaccine history.
  1. Laing SK, Griffiths U, Raza AA, Zulu F, Yakubu A, Bessias S, Ozawa S. An investment case for maternal and neonatal tetanus elimination. Vaccine. 2020;38(9):2241-9.
  2. Vos, T. et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396, 1204–1222 (2020).
  3. Dalal S, Samuelson J, Reed J, Yakubu A, Ncube B, Baggaley R. Tetanus disease and deaths in men reveal need for vaccination. Bull World Health Organ. 2016 Aug 1;94(8):613-21.
  4. Guzman-Cottrill JA, Lancioni C, Eriksson C, Cho Y, Liko J. Notes from the Field: Tetanus in an Unvaccinated Child — Oregon, 2017. MMWR Morb Mortal Wkly Rep 2019;68:231–232.
  5. Causey K, Fullman N, Sorensen RJD, Galles NC, Zheng P, Aravkin A, Danovaro-Holliday MC, Martinez-Piedra R, Sodha SV, Velandia-González MP, Gacic-Dobo M, Castro E, He J, Schipp M, Deen A, Hay SI, Lim SS, Mosser JF. Estimating global and regional disruptions to routine childhood vaccine coverage during the COVID-19 pandemic in 2020: a modelling study. Lancet. 2021 Aug 7;398(10299):522-534.