Ask Dr Gary: Jab far, far better than lockjaw

Less people are getting their children vaccinated. Photo / File

In what may be a trend, I am seeing more people who, having earlier decided not to have their kids vaccinated, change their minds when faced with the prospect of actual disease. Lately, it's been tetanus.

People don't want their kids to have the discomfort of vaccination, or the chance of an adverse reaction, so the kids are not immunised. Then one day their child gets a deep cut, big splinter, dog bite or puncture wound.

Tetanus is caused by bacterial spores that are present all around us, especially in soil and manure. The bacteria grow best in deep or dirty wounds. Washing wounds thoroughly and immediately with soap and water is recommended, but for deep puncture wounds it's not enough. If enough tetanus spores are in a wound, symptoms can occur a week later, with agonising muscle spasms that can gradually involve the entire body and go on for weeks.

People with severe cases end up on ventilators in the intensive care unit. Even with medical treatment, 10 per cent die and those who survive require months of rehabilitation.

In New Zealand, an average of five people a year get tetanus, almost all of them having not been immunised.

The vaccine is almost 100 per cent effective. But because we never hear about an actual case of tetanus, it's easy not to bother with vaccination.

When non-immunised people do get dirty wounds, catching up will mean getting a tetanus shot as well as a special shot of tetanus immune globulin, an antibody product taken from donor's blood that carries a small risk of infection as well as immune system side-effects.

It's often this way with vaccinations: we don't like injections or sore arms, but the alternatives usually are worse. The immunoglobulin (a fancy word for antibodies) gives immediate protection, while the vaccine takes two weeks to effect protection, which then should last us for years.

Gary Payinda MD works as an emergency physician, and would like to hear your medical questions. Email drpayinda@gmail.com (This column provides general information, and is not a substitute for the medical advice of your personal doctor.)