Tetanus remains a rare but serious disease in the United States, with health experts highlighting the importance of regular booster shots, according to information released on March 26. The discussion comes as cases of pertussis, or whooping cough, continue to rise nationally and in Colorado.
The issue is significant because while tetanus is uncommon due to widespread vaccination efforts, its consequences can be severe. In addition to protecting against tetanus, the recommended booster shot also guards against diphtheria and pertussis—diseases that are seeing increased incidence rates.
Tetanus is caused by a toxin produced by Clostridium Tetani bacteria found in soil and excrement. The spores typically enter through wounds or punctures and can lead to painful muscle contractions known as lockjaw. Without treatment, tetanus has an almost 100% fatality rate. In countries with low vaccination rates, nearly 20,000 people died from tetanus in 2023 alone; most victims were young children or newborns whose mothers had not been vaccinated.
Vaccination programs have drastically reduced U.S. case numbers: there were only 38 reported cases nationwide and one in Colorado in 2025. Most involved individuals who had never completed their childhood vaccine series or had missed recommended boosters every ten years as advised by the Centers for Disease Control and Prevention (CDC). Some recent research suggests that adults fully vaccinated as children may not need additional boosters—a change that could align U.S. policy with World Health Organization guidelines—but Dr. Michelle Barron of UCHealth supports current CDC advice due to added protection against other diseases like diphtheria and pertussis.
Whooping cough has become more common recently: last year saw over 28,000 cases across the country—including more than a thousand in Colorado—the highest since 2014. Measles is also making a comeback; there were over two thousand documented U.S. measles cases last year compared with just six total between 2014 and 2024 in Colorado alone.
“While tetanus/diphtheria may or may not need to be boosted in adults, the decline in childhood vaccination and the siege on funding for public health will impact the rates of these vaccine-preventable diseases and will have many second- and third-order effects that have not been fully realized,” Dr. Michelle Barron said via email. “Just looking at the increasing rates of pertussis and the current measles outbreak should give everyone pause about what the future holds.”
The ongoing resurgence of so-called ‘old-world diseases’ highlights concerns among public health officials about declining vaccination coverage.
