Too Many Shots

Virtually every U.S. infant born under a doctor's care gets three shots, spaced a month apart, of a three-way vaccine against diphtheria, whooping cough and tetanus, or "lockjaw." Most children receive a booster shot a year later. Many get additional tetanus toxoid boosters in school or college--and, of course, in the armed forces.

Are all these shots necessary? No, says a group of experts headed by Harvard's Dr. Thomas C. Peebles, who shared a Nobel prize for his part in the research that made polio vaccines possible. The experts do not intend to minimize the importance of vaccination against tetanus, the infection that usually results from deep and dirty wounds in which the tetanus bacteria can thrive without air. Every year it kills almost 200 Americans, the doctors point out in the New England Journal of Medicine.

The trouble with tetanus vaccination programs is that while some people never get the highly desirable shots, others may get too many. Anyone who suffers a dirty wound more than a year after his last tetanus shot is almost certain to receive yet another booster. This is not necessary, judging from detailed laboratory work by Peebles and others. Men and women, they maintain, retain their immunity against tetanus for twelve or more years after those first four shots in childhood, and certainly should not need a booster more often than every ten years. More frequent revaccinations are not only unnecessary but potentially dangerous, say the doctors, since they may provoke allergic reactions against the toxoid itself.

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