Tetanus is rare in Canada. During the 1920s and 1930s, between 26 and 55 deaths due to tetanus were reported annually. With the introduction of tetanus toxoid in Canada in 1940, morbidity and mortality rapidly declined (see Figure 1). Between 2000 and 2013 a total of 42 cases were reported, with an average of 3 cases reported per year (range 1 to 8 cases). During this period, persons 60 years of age or greater accounted for 55% of the cases. No cases were reported among neonates. The immunization status of most of the reported cases was not known.
Only six deaths have been reported in Canada since 2000, with the last death reported in 2010.
Being fully vaccinated is the best protection against tetanus.
Immunization of all children with a tetanus toxoid-containing vaccine is recommended at 2, 4, 6 and 18 months, with a booster dose at 4 to 6 years.
Teenagers and adults should receive a tetanus booster every 10 years (recommended at 15, 25, 35, 45 years, etc.). Adults who have not previously received a primary series (at least 3 doses) of tetanus toxoid-containing vaccine should receive one dose of Tdap-IPV vaccine followed by two doses of Td-IPV vaccine.
In cases where an individual has been injured, potentially exposed, and suspected of not having sufficient immunity to the bacteria, a vaccine and antitoxin may be administered.