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Tetanus is rare in the United States thanks to widespread immunization, but because herd immunity does not apply, unvaccinated individuals remain vulnerable. From 2009–2023, 402 cases occurred in the U.S., resulting in 37 deaths. Most cases were in adults, but an average of four occurred in children each year. In July 2024, Idaho saw its first pediatric tetanus case in over 30 years, prompting the CDC to evaluate all four pediatric cases reported that year. The cases occurred in four states and across a range of age groups (<5 to 10–15 years).
None of the four children had received tetanus vaccination before their injury.
Two children sought care shortly after injury and were offered postexposure prophylaxis, but their paren…