Revisiting Tetanus

. . . still it aches like tetanus, it reeks of politics. . .

Forgotten Years, by Midnight Oil

When I was a kid, that’s all I knew about tetanus.  The shot makes your arm ache.

Then I grew up and went to nursing school, and then I took care of the woman who died because she cut her foot on a screen door.  And I have never thought about tetanus the same way since.

And this just makes me sort of tired, frankly.


A nice little anecdote, written by Dee Resnick Forlano. 

She appears to be a pretty vehement anti-vaxxer who is also anti-circumcision, and in addition, she crochets.


I do not know if she raises rabbits.

And I know that none of that matters when it comes to the veracity of the little story, but the way the whole thing is worded is interesting.

Story from a mom who took her child to the emergency room with a cut (vaccine free):

That’s how it starts.

Then it ends with the author’s name.

So did this incident happen to Forlano, or is she retelling an incident that some mother told her, thus making it very much second-hand, or maybe third or even twelfth-hand?

I have no idea.

We are not told how old the child was (and the age of the child and the child’s “vaccine free” status affects which vaccine should be given).  We’re given few details.

But it’s interesting to me that the parent took the child to the emergency room for a cut.  To do that, one would suppose this was something that couldn’t be taken care of with some warm soapy water and a small bandage.

I am going to make an assumption here. I am going to assume that this parent believed that her child needed something done to this cut that she could not do for her child at home.  What might that be?

It might be suturing.  In fact, it most likely was suturing, or at least an evaluation to determine if stitches might be needed.

You know what they do when they suture a cut? They typically begin by deadening the area with lidocaine.

Notice that Mother Know-It-All did not challenge the physician about the lidocaine used?  It’s an injection.

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Oh, my god.  Look at that. Lidocaine has a preservative in it. What in the hell is that?


Oh, shit. It’s a potential fuck-with-your-hormones thing.

And they were giving it to a child.


There is also a version that is methylparaben-free (notice that in the first screen shot).

But did our Mother Don’t-Need-No-Medical-School even ask about that?

She doesn’t say.  She’s too busy bragging about how she supposedly stumped the doc on the tetanus thing.

What did they clean the cut with?  Does she know? Did she ask?  Might it not be chemicals?

Was the cut sutured?

What is in the suture material?

I can go on and on, but you get the idea. If the doctor is so damned dumb that she has to school him on what vaccine to give a child—a doctor in an emergency room who presumably deals with this every working day of his life and who spent years in medical school—then why in the world did she even go?  Why not just sew the cut up herself?

I strongly doubt this story even happened. I suspect that if there was a mother and if there was a child and if they went to the ER to get a cut taken care of and if the mother refused to let the child be vaccinated, the conversation did not go the way the story describes it.  This reads more like the fantasy-conversation of an anti-vaxxer who is practicing in the shower.

But there’s more.


This was tacked on to the end of the Braggart Mother anecdote.

There are two sections, both numbered.

Let’s start with Section One.

. . . if the wound bled, NO tetanus.

This is the single dumbest thing I ever read. It’s patently false. My patient who cut her ankle on the screen door bled. Her cut bled, folks.  And she died of tetanus. So honestly, this is stupid.

The assumption here is that the tetanus bacteria is anaerobic, and can’t survive in oxygen, so give it oxygen and all will be well.  I don’t know what bleeding has to do with anything, except that whoever dreamed this up might think that since red blood cells carry oxygen, then Clostridium tetani can’t survive in blood. I assure you it can and does.  Red blood cells bind oxygen.  It’s not just floating about.

One other thing that I find just jaw-dropping in the faulty reasoning of these folks is that they love to carry on about how Clostridium tetani is everywhere.

Tetanus spores are everywhere in the environment. On your bookcase, in your back yard, in clothing and house dust and in your mouth and feces. Tetanus has been known to follow surgery and innocuous procedures such as skin testing or intramuscular injections of medications and vaccinations themselves.

This comes from a poorly written, very dated article that Forlano cited on her Facebook page.

Please explain to me how, if Clostridium tetani just plain lies down dead if exposed to oxygen and is rendered completely harmless due to being a corpse, you can have it on your bookcase and on your clothing and skin?

Number Two:

Tetanus is normally found in manure/dirt and not on a clean plumbing fixture.


In the first place, my patient who died from tetanus cut her foot on a screen door. She lived in the city.  It wasn’t a dirty screen door. It was just a regular screen door.  It is true that being rusty is not a problem. We always hear the “rusty nail” thing, but the rust itself isn’t the issue.  The “rust” thing comes from the idea that the nail has been lying in the dirt.

But then what about the bookcase?

Make up your minds, folks.

Number Three:

. . .you literally can NOT “vaccinate” against a bacterial infection AFTER the exposure.

That is correct and that is the reason that you jolly well better get a tetanus series before you have a cut.

But here’s how we treated the patient I took care of.  She got a tetanus vaccine (nobody knew she was going to die).  She also got the tetanus antitoxin, which is not a vaccine at all, but basically a syringe full of antibodies given to try to help her immune system kill off the bastards that have invaded.

And the writer of this ridiculous collection of nonsense mentions that in Number Five.

It’s important here to stop and understand what tetanus is and how it works and why it’s different from, say, pneumonia.

Clostridium tetani by itself doesn’t do anything to anyone. It’s a bacteria that lives all over the place but primarily in soil and most primarily in manury soil.  That’s because there are fairly high populations in the gut of horses, cattle, chickens and other farm animals.  So if you garden with manure, well, you are exposed to it quite often.

When Clostridium tetani gets in a nice, warm, oxygen-free place, it begins to produce a substance that we call a “neurotoxin.” Neurotoxins, you guessed it, affect the nervous system and that’s why the muscles of a patient with tetanus go berserk.

There are four different types of tetanus.  My patient had generalized tetanus.  It was all over her body. This type is often fatal, as happened to her.

Tetanus can present in a localized form, where the resultant muscle spasms only occur in the area right around the wound, and this type is generally not fatal.

If you happen to have a head injury, tetanus can affect the cranial nerves. It can just stay there, causing a palsy, or become generalized.

And finally, tetanus can occur in neonates (new-born babies). It’s due to the bacteria being introduced during the cord cutting or during  birth injury.  More about that later.

But remember, Clostridium tetani, by itself, doesn’t cause any of this. The toxin does.

And it’s a crap shoot determining exactly how much bacteria got into a wound, and exactly what the conditions are inside the wound (yes, you wash the dirt out of a wound, but that won’t stop the bacteria if it got in there and you cannot tell if it did or not), and hence, how much toxin might be produced and what type and how it will affect the victim.

There is no “tetanus vaccine” available in the United States. . .

And Number Five is correct. The vaccine in the United States comes as a package deal.  It’s always combined with a diphtheria vaccine and sometimes pertussis (whooping cough) as well.

I’m not sure what the point is here.  It’s done that way for convenience.

We vaccinate our calves against clostridium bacteria. Imagine how much exposure a calf gets to tetanus.  It lives in his gut and cattle lie down in their manure (especially in winter because it’s nice and warm—the bath Frances gets when she comes from milking in that condition is not, but I haven’t been able to get her to understand cause and effect).

click image for link to source

Look at that list. Usually, the first sign you get that one of your cattle is sick with one of those diseases is when you find the dead animal.  They die in a matter of hours.

We do not like losing cattle. No farmer does.  It’s not only gut-wrenching, it’s also a financial hit.

So we vaccinate.

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See the “8” in the title of that vaccine? There is also a “6-way” and a “7-way” and god knows what else. I can’t keep them all straight and rely on Jason to know what is needed. There are different configurations of these vaccines meant for different areas of the country, different ages of cattle and different conditions.

But the “8” means that vaccine contains a vaccination against eight different clostridial diseases.  One shot, eight diseases.

Look at the price.  It varies depending on what size vial you buy. The smaller vial for $38.95 vaccinates a herd of 10.  That’s my size.  The larger one has fifty doses and would expire before I used it all.

Regardless, this shit is not cheap.

And remember, with farmers, cattle illness and/or death is devastating not just emotionally, but also financially.  The profit margin raising cattle is slim, slim, slim.  Like, really slim.  Nobody is going to spend almost $4 per head vaccinating with something that puts their livelihood at risk and that does not protect them from something that the farmer knows is a danger because he’s seen it happen and never wants to find a dead calf again.

Not only do we vaccinate our calves, we also vaccinate Frances.  She has gotten all her routine stuff, of course, but she also gets a shot just before she calves (maybe a month or so) to make sure she passes on as many antibodies as possible via that all-important colostrum to her calf.

Our calves are vaccinated when their horns are burned off.  It’s convenient to do it then and they are the right age.  You cannot imagine what a rodeo ensues when you’re trying to catch unwilling 200-pound calves and flip them onto the ground so you can put a hot iron on their forehead. They object strenuously.  They barely feel the vaccination.

So, considering that farmers are hard-headed pragmatists of the worst type, and pinch pennies until they bleed, and they vaccinate for eight diseases at one pop, knowing that not doing so can cause them great misery, and necessitating wrestling with the calves to do it, combining three for children is nothing.

And now for the “summary”:

Number one:

A tetanus shot would not help a current case of tetanus as a vaccine takes several weeks to create antibodies.

What most people get when they go to the ER with a cut is a “booster” shot.  It’s intended to do just what it’s called: boost the original immunity that is provided by the original series of shots.

Number two:

According to the VAERS database, reactions to vaccines for tetanus and diptheria are not rare. As of August 2012, there were over 22,000 adverse reactions reported and 67 deaths.

Ah, now we cite some figures. What in the hell is the “VAERS” database? Notice how they just flop that out there like it’s some definitive thing?

The Vaccine Adverse Event Reporting System (VAERS) is run by the CDC, and that means every word on it is reliable and factual, right?  These people trust nobody. They don’t trust science. They don’t trust doctors. But when they want to make their case, they cite the CDC. The rest of the time, the CDC is lying.

At any rate, VAERS is not some sort of scientific database.

click image to link to source

Notice that?  Any member of the general public can submit a report saying that little Johnny ran a fever after he got his MMR.  Anyone.  Anti-vaxxers can do this (and I bet they do regularly).


What the author of the silly little screed is trying to do is use VAERS data to do exactly what the CDC goes to some trouble to explain that you cannot do.  That statistic about adverse reactions and deaths is meaningless.

And Number three:

Lastly, the CDC states that efficacy of the tetanus toxoid has never been studied in a vaccine trial.

Of all of them, this is just amazing to me.

Here’s where they get that statement.

But they leave out some stuff. A lot of stuff.

From the same CDC paper:

Tetanus toxoid was first produced in 1924.

That makes it old. Really old. That’s a long time ago in terms of vaccines and medications in general.

If you want to read a very interesting book about this subject, try “The Demon Under the Microscope,” by Thomas Hager.

There were no “clinical trials” in those days, unless you count just giving some of whatever it was to a patient and hoping like hell it worked.

entire CDC qutoe
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Notice that statement?

. . .cases of tetanus occurring in fully immunized
persons whose last dose was within the last 10 years are
extremely rare.

Bitching about the lack of “clinical trials” in a vaccine that was invented in 1924 and has been in constant use with virtually 100% efficacy since then is like saying “Well, we don’t know if aspirin will cure a headache or not. There have never been any clinical trials.”

One of the doctors I worked with once addressed the issue of “how long does the tetanus vaccine stay effective.”  The answer is basically that nobody is sure.

As the CDC says quite clearly, “. . . some persons may be protected for life. . . ”
The issue here is how does one go about determining exactly how long the tetanus vaccine lasts?  How do you do a “clinical trial”?  Who is going to volunteer to be the person who gets the placebo and then is exposed to tetanus?

The vaccine has been around for nearly 100 years. It creates with almost no exceptions, 100% immunity in people who get the entire series and keep their boosters up to date (NOTE TO SELF:  get a tetanus shot, I think it’s been more than ten years).

Medicine may not have a handle on everything, but they’ve got this.

And one addendum:

Forlano, on her FB page, cites a really terrible article which I referred to above, and the author there makes an incredibly dumb statement.  However, it’s a very dumb argument often made by anti-vaxxers, so let’s look at it.

While the medical profession likes to take the credit for ALL the decline of tetanus courtesy of a vaccine, this is simply NOT true.

The proof of that lies with neonatal tetanus in the developed world, which DISAPPEARED well before the existence of either anti-toxin or a vaccine.

And the person includes a little graph with some added arrows.
See? There you have it.  Tetanus just was waning and vaccines didn’t do anything.  You know, along with measles and mumps and whooping cough and smallpox.

Only we’re talking here about neonatal tetanus.

Tetanus that occurs in newborn babies due to unclean conditions at birth, often when the cord is cut.

Clean up the birth and you’ve greatly reduced the possibility of neonatal tetanus.

Vaccines had nothing to do with and still don’t.  Nobody has ever claimed that they did.

But what vaccines have done is reduce the incidence of generalized tetanus, the kind that can kill you, dramatically.  Of course, when the stats don’t say what you want them to say, well, come up with something else.

And one last thing:  Here is a quote from that horrible article, just plucked at random.

“It is the compromised host, or traumatised patient, either by surgery or accident, who is most apt to develop tetanus.” (J Foot Surgery Vol 23, No 3 p235).

Oh, wow, gee, that’s a real quote, isn’t it?  I mean, he has references and everything, even a page number.

Well, if you take that quote and plunk it into Google, this is just small part of what you get.


And it goes on and on.  They all quote that same quote, down to the exact part with the exact same citation.

Obviously, nobody looked this up. Everyone just copied and pasted from one original source.

So it’s the Journal of Foot Surgery, it appears.

I can’t find the article. I’ve searched and devoted all the time to it I care to waste.

The point is that nobody looks stuff up. The quote is sort of meaningless unless it’s placed in context. Who wrote this? When? (I think this might be from a many decades-old article).  But this what is done. The quote is cited, everyone who wants to use it does so without checking. They just cut and paste.





Probably the most egregious anti-science bullshit involves the idea that man’s role climate change is a “hoax.” This doesn’t seem terribly sexy to talk about because it has no real immediate personal threat to anyone, but the long-term consequences are real and pretty horrible.

So, in the grand scheme of things, I don’t rate anti-vaxxers up there with climate-change-deniers, but they are still way up on the Stupid Morons Who Don’t Have Any Brains Scale.

And of course, many of the first group are also in the second group.  It seems that once you begin to accept as true things that are quite clearly not true at all, there is almost no limit to the amount of horse manure you will swallow quite happily.

I have no idea where Nicole obtained her figures because she doesn’t tell us. [Personally, I tend to just jettison figures when somebody online tosses them out without reference to anything, but that’s just me, I suppose. I like for my facts to be actually true.]


So, the CDC readily tells us that the vaccine’s effectiveness fades over time. This is true, by the way, of most vaccines.  Think of it like this: the antibodies produced by the vaccines get “old.” They more or less reach their expiration date. That’s why they break the vaccine into several parts and give it over and over again.

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Now, I want Nicole to tell the 277 mothers who lost their babies to whooping cough that “fever, crankiness, headache, fatigue, and soreness” are about the same as having whooping cough. Their babies died.


But I want to focus on the last sentence.

You probably should just boost your immune system instead of compromising it with chemical cocktails.

Let’s take the first part. . . well. . . first.

I am so sick and tired of people who go around telling other people to do this or do that or eat this or take this to “boost your immune system.”

What in the hell does that even mean?

Nicole Naugler is a dog groomer. She washes dog butts for a living. She has a high school education. She gets her information, when she bothers to link to it, from anti-vaxxer sites. What would she know about immune systems?

In the first place, you can’t really “boost” your immune system.

Consider AIDS.  That stands for “acquired immune deficiency syndrome.”  AIDS is caused by a virus that actually does attack the human immune system. This is the reason that AIDS patients are so susceptible to everything.  But note the first word?  “Acquired.”

It didn’t just happen spontaneously.  This immune deficiency thing was “acquired” by getting the virus.

In 1918, during WWI, there was a world-wide outbreak of a very deadly form of influenza.  It killed more people than the war did, somewhere between 20 and 40 million people.

Why was it so deadly?  Flu is bad, and kills a whole lot of people every year, but that version was especially severe. The reason, in part, was the horrible conditions that so many soldiers were living in (crowded, unsanitary).  But another reason was that nobody had any immunity to it.

Remember the stuff I wrote about the various types of flu? If you don’t, go read it now.

The problem seems to be that in the 1918 version, nobody had ever been exposed to any of the proteins on the surface of that particular flu virus, so nearly everyone exposed caught it and nobody had any immunity or even any partial immunity.

The immune system is not “strong” or “weak,” although those are words you hear about it all the time. The immune system either functions or it doesn’t.  If you are susceptible to a disease, like the 1918 flu, it means that you simply don’t have any antibodies on board and your immune system, even if it is functioning beautifully, cannot attack a virus it doesn’t recognize as dangerous.

What the AIDS virus does is destroy the immune system’s ability to do that, to recognize invasive organisms and wipe them out.

What you eat doesn’t have a single thing to do with this.  “Chemicals” don’t have anything to do with this.

Furthermore, there is no reason to “boost” the immune system, even if it were possible, which it isn’t. You don’t want it “boosted.”  You simply want it to work properly: to recognize disease-causing organisms that shouldn’t be there, and say, “Aha, you SOB!” and destroy them and then retire for a nap.

Do you know what an autoimmune disease is?

There are about a dozen main ones.  They are believed to be caused by the same general problem: an immune system that goes rogue, acts like it’s on steroids and starts destroying cells willy-nilly.  Celiac disease, which my mother has, is one. It is basically a genetic disorder. That means that I am at risk for developing it (although having made it to 67 without it, I assume that my risk of getting it now is pretty tiny – my doctor doesn’t consider it an issue).  What I eat or don’t eat has no effect whatever on that risk.  “Chemicals” don’t cause it.  Genes do.

But the important thing here is that autoimmune diseases are what happens when an immune system is “boosted.”  We don’t want that, folks.  We want the system to function normally, but not to go bonkers.

But Nicole tells us that instead of getting a proper vaccine, which provides the immune system with the fucking information it needs to know which organisms it encounters are disease-causing and need to be eradicated, we should just worry about not “compromising” our immune systems with “chemical cocktails.”

This woman tells us that in all seriousness. This woman whose idea of a great treat is a trip to Hardee’s and having chocolate cake made at the bakery and bought as a mark-down for breakfast.  [Disclaimer: I just finished a piece of chocolate cake with chocolate icing. It was delicious. It didn’t do a single thing, pro or con, to my immune system, though.]


Here’s the bottom line:  When you read that you should do this or that, or eat this, or don’t eat this, or take this pill or that concoction, because it will “boost your immune system,” run.  Quit reading.  You’re reading advice from a lunatic.

Instead, if you really want to know more about this, read this.

The article echoes much of what you’ll find in more scientific articles but with less scientific jargon. The author has an post-graduate education in science, so is qualified to write about it. And that illustrates the two major things I look for when I’m trying to figure out what is true and what is bullshit.  Here’s another one, from Harvard.

Does the piece I’m reading repeat stuff I can find at other reputable sites?  “Reputable site” does not mean “”  Or when I Google, am I finding the same position repeated over and over at bullshit sites?  (Big red flag)

And who is writing?  Who is this person? What is his/her educational background? What does he know, if anything?


My thanks to a reader who sent me this link.

Here’s the original posting written by the stupid woman.

I warn you, the article will make you angry. I was so angry reading it that I was nearly shaking. It happened long enough ago that reporting the woman to CPS is not feasible – and I’m sure a lot of people did.

People who do this to their children should have their children removed by the state.  Period. And they should never, ever get them back.

This was not about those kids. This was all about Heather being Mother of the Year.  She’s not Mother of the Year, she’s a motherfucking idiot.

Read it, Nicole. I dare you. Read all about how easy it is to take care of whooping cough at home without medical aid.  Read about how it’s just like having a few side effects from a vaccine.  Read about what a stupid idiotic dumbass you are.