Recent reports indicate a concerning rise in tetanus cases in the United States, with confirmed instances increasing from an annual average of 15 to 28 in recent years, reaching at least 37 cases this year—the highest number in over a decade. This uptick is attributed to declining vaccination rates among young children, particularly in states vulnerable to natural disasters exacerbated by climate change.

The tetanus vaccine, typically administered in combination with diphtheria and pertussis vaccines, has historically been effective in preventing the disease. However, an investigation by NBC News and Stanford University revealed that over 75% of U.S. counties have seen a decrease in the administration of the diphtheria-tetanus-pertussis (DTaP) vaccine since 2019. Unlike many infectious diseases, tetanus is not transmitted from person to person, meaning that herd immunity does not apply; however, lower vaccination rates increase the overall vulnerability of the population.

Symptoms of tetanus can appear between three to 21 days after infection and include painful muscle spasms and difficulty breathing. The bacteria that cause tetanus are commonly found in soil and manure, and infections can occur through puncture wounds. Treatment for tetanus can be intensive and costly; for example, a case involving an unvaccinated child in Oregon resulted in nearly $1 million in medical expenses.

Healthcare professionals stress the importance of vaccination, noting that the costs associated with treating tetanus far exceed the price of preventive vaccines. The increasing frequency of natural disasters, such as hurricanes and floods, poses additional risks, as individuals may sustain injuries while navigating debris, further raising the likelihood of tetanus exposure.

States like Florida, Texas, and Kansas, which frequently experience severe weather events, have reported significant declines in vaccination rates. For instance, Florida's kindergarten DTaP vaccination rate fell from 94.1% in the 2016-17 school year to 88.8% in 2024-25, while 85% of counties in Texas have experienced decreases in vaccination rates since 2019.

In parallel, Robert F. Kennedy Jr. has proposed aligning U.S. vaccination policies with Denmark's model, which includes ten recommended vaccines for children, focusing on established diseases. This proposal, which aims to reduce the U.S. vaccine schedule, was set to be announced by the Department of Health and Human Services (HHS) but was postponed due to legal objections and scheduling conflicts. Kennedy's leadership at HHS has faced scrutiny for its decision-making processes, which have deviated from expected bureaucratic protocols.

Tracy Beth Høeg, a physician and epidemiologist at HHS, has expressed support for the Danish model, citing concerns about aluminum exposure from vaccines. This perspective aligns with a broader skepticism regarding vaccine safety, despite extensive research, including a study from Denmark involving over a million children that found no evidence linking aluminum in vaccines to adverse health outcomes.

The implications of both the rising incidence of tetanus and the proposed changes to vaccination policies are significant, particularly as climate change continues to intensify the frequency and severity of natural disasters. Experts warn that without renewed focus on vaccination, the health of vulnerable populations may be jeopardized, underscoring the need for public health initiatives that address both vaccination and the broader impacts of climate change on health outcomes.