Many Teens and Adults Lack Protection Against Tetanus and Diphtheria (TD), Other Vaccine-Preventable Diseases


DENVER -- With summer school classes in session and September just a few weeks away, many parents and teens may not be thinking of their own immunization status, often because immunizations are not mandatory for adults and many teens. The National Association of School Nurses (NASN) is urging families as a whole, particularly teens and adults, to review their immunization status for various infectious diseases such as tetanus and diphtheria, and get up-to-date immunizations.

"What we are advocating is a 'whole family' wellness visit: ideally, one member of each family will push for an assessment of everyone's immunization status with regard to tetanus and diphtheria," says NASN president Janis Hootman, PhD, RN, BSN, MST. "Immunity against these two diseases does not last forever and many older children could need a Td booster shot as early as age 11. It is important to know your immunization status and receive a Td booster once every 10 years after childhood."

While an estimated 94 percent of children under 6 years of age are currently protected against tetanus and diphtheria, the Centers for Disease Control and Prevention (CDC) estimates that 53 percent of Americans over the age of 20 are no longer protected against these two diseases.

Last year a nationwide shortage of Td boosters, required for school-entry, forced many older children and adolescents to fall behind on their booster schedule. Shortages are now over which means these age groups should "catch up" on their vaccines before the next school year begins.

"The summer months represent one of the few windows of opportunity where the entire family can schedule a doctor's visit to catch up on their immunizations," says Hootman. "NASN is encouraging all family members -- especially teenagers and adults -- to get their Td booster dose if necessary and also to review their immunization status for other vaccine-preventable diseases."

NASN is raising awareness of tetanus and diphtheria prevention as nurses typically receive calls about what vaccines are needed before a child can enter school. The school nurse can also take advantage of this opportunity to not only answer these questions, but also inquire about the vaccination status of the parent and/or other household members.

"Tetanus is a common bacteria found in the environment and can be caused by more than just stepping on a rusty nail. Something as simple as a splinter from playground equipment or a scraped knee during recess could also be potential sources of tetanus infection," notes Hootman.

Immunization is the best way to protect against tetanus and diphtheria infection in the U.S. According to the CDC, adults and adolescents require a booster shot every 10 years throughout life to maintain protection against both diseases.

"The examples and lessons you instill now in younger family members are the same patterns they will carry with them for the rest of their lives. Ask your doctor about a Td booster shot and have the piece of mind that your entire family is protected against these diseases," says Hootman.

Teachers, nurses and administrators play an influential role in shaping the health patterns of the children they educate. Some children are at an elevated risk for Td exposure if they were unable to receive a Td booster due to shortages in the US last year. These students may need 'catch-up' immunizations in order to confer the maximum disease protection the booster vaccine offers.

Despite the official recommendations for adults to get Td boosters every 10 years, 70 percent of the cases in the U.S. over the last two decades were among persons 40 years of age or older. According to the CDC, the percentage of tetanus cases among persons aged 29-59 years old has increased during the last decade; previously, most cases were among persons aged 60 years and older.

Almost all reported cases of tetanus (children especially) occur in persons who have either never been vaccinated, or those who completed a primary series but have not had a booster vaccination in the past 10 years.

According to NASN, although diphtheria is uncommon in the US, there is also a high risk that the disease could increase in the general population due to fewer people maintaining up-to-date immunizations, resulting in a dangerous comeback of the disease. One such instance, where diphtheria made a comeback due to lack of adult immunity, was in Russia from 1990-95. Because a large number of people were not immunized, this particular outbreak resulted in more than 157,000 cases and 5,000 preventable deaths.

For more information about tetanus or diphtheria, visit:

* NASN at

* National Foundation for Infectious Diseases' (NFID) at

* CDC's National Immunization Program at

* Immunization Action Coalition at

The NASN is a non-profit specialty nursing organization incorporated in 1979, which represents school nurses exclusively.

Source: National Association of School Nurses

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