Tetanus in France: epidemiological data 2021

Tetanus is a severe, non-contagious, often fatal, acute infection that most often requires hospitalization in intensive care. It is due to exotoxins produced by an anaerobic gram-positive bacillus, a bacterium called Clostridium tetani, naturally present in the soil. Contamination can occur through any ordinary wound, cut, or wound. Generalized tetanus is a notifiable disease in France. Vaccination is, together with the administration of immunoglobulins in case of injury, the only possible prevention.

Due to the generalization of tetanus vaccination, tetanus infections have become very rare in France and in all industrialized countries, but they have not completely disappeared. Thus, the disease mainly affects the elderly who are not or are poorly vaccinated.
However, it can affect anyone who is not up to date with their vaccinations, thus, in the last 10 years, 3 cases have been reported in children aged 3 to 8 years at the time of the disease, and who had not been vaccinated, although he was born in France, a country where primary vaccination has been compulsory since 1940.

The key figures of tetanus

Tetanus in France from 1960 to 2021: reported cases and annual deaths

Fig - Tetanus in France from 1960 to 2021: reported cases and annual deaths

The importance of the tetanus vaccine and boosters

Public Health France recalls that the prevention of tetanus infection is carried out by vaccination, compulsory in France for all babies since 1940. The vaccine has existed for more than 70 years and shows almost perfect efficacy and safety.

Thus, in infants and children, the vaccination schedule provides for a primary vaccination consisting of two doses of combined vaccine 2 months apart, administered at 2 and 4 months of age, followed by a booster dose at 11 months. This primary vaccination is mandatory for children.
Subsequent boosters should be done at the age of 6 years and then between the ages of 11 and 13. In adulthood, boosters are given at ages 25, 45, and 65 and then every 10 years (at 75, 85, 95, etc.) taking into account immunosenescence.

In unvaccinated adults, the primary vaccination consists of 2 doses 2 months apart, with a booster 8 to 12 months later, then resumption of the vaccination schedule according to age, respecting a minimum interval of 5 years from the last injected dose.

Since tetanus is not a disease that can be transmitted from person to person, high vaccination coverage in the population does not protect unvaccinated or poorly vaccinated subjects. Only complete individual vaccination (including boosters) protects against infection.

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