Philosophic Objection to Vaccination as a Risk for Tetanus Among Children Younger Than 15 Years

Elizabeth Fair, Trudy V. Murphy, Anne Golaz, Melinda Wharton

Characteristics of Cases of Tetanus

CaseAgeGenderStateYearTetanus Toxoid HistoryDescription of InjuryPunctureTime to TIGLength of HospitalizationVentilatorReason Unvaccinated/Time Since Last Dose
17 dMTN19951 TT*Umbilical woundNo7–23 h60 d30 dPartially vaccinated—18 y
29 dFMT19980*Umbilical wound/contaminated clayNo7–23 h19 d12 dPhilosophic—mother unvaccinated
33 yMMO19950Bug bite on legYes15+ d24 d9 dReligious—Assembly of Yahweh
44 yMIN19990Stepped on wire in barnYes5–9 d26 d22 dReligious—Amish
55 yMFL19990Stepped on thornYes1–4 d10 dNoReligious
68 yMMI19920Stepped on stickYes36 dYes (>18 d)Philosophic
78 yMCA19980Puncture and abrasion on hand and footYes1–4 d12 dNoPhilosophic—personal belief exemption
88 yFOH19980Kicked tree stump in yardNo6–8 wkYesReligious—Amish
99 yMPA19950Splinter in bare footYes5–9 d38 dNoReligious—Amish
1012 yMMO19920Stepped on nail in barnYesRefused TIGNoReligious—Amish
1112 yFTX19945 DTPStepped on rakeYes5–9 d1 d 6 wk home careNoVaccinated—4 y
1212 yMWV19970Stepped on nail in barnYesRefused TIG60 dYesReligious—belief in holistic medicine
1312 yMPA20000Concrete block fell on elbowNo1–4 d16 dNoReligious—Amish
1413 yMMI19920Cut finger at homeYes10–14 dYesReligious—Amish
1514 yMPA19976 DTPSmall dog bite on lower calfYes7–23 h3 dNoVaccinated—2 y
  • DTP indicates diphtheria and tetanus toxoid, and pertussis-containing vaccine; TT, tetanus toxoid-containing vaccine.

  • * Maternal vaccination.

  • Confirmed by vaccination record.

  • Categories for the interval between the onset of symptoms and receipt of TIG included <7 h, 7–23 h, 1–4 d, 5–9 d, 10–14 d, and >15 d.