On Wednesday, August 27, 2025, researchers at Oregon Health & Science University (OHSU) announced that the United States could safely discontinue tetanus and diphtheria booster vaccinations for adults, which could save the country an estimated $1 billion annually. This recommendation depends on maintaining strong childhood vaccination coverage.
Lead author Mark Slifka, Ph.D., a professor of microbiology and immunology at OHSU, stated that maintaining high childhood vaccination rates not only protects children but may also allow for a reduction in adult booster vaccinations without compromising public safety. He noted that this change would align US guidelines more closely with those of the World Health Organization.
The research review, published in the journal Clinical Microbiology Reviews, supports earlier OHSU studies from 2016 and 2020, which found that the combined tetanus, diphtheria, and pertussis vaccine (DTaP) provides immunity lasting at least 30 years, far exceeding the current US Centers for Disease Control and Prevention (CDC) recommendation of boosters every 10 years for adults.
In the US, childhood vaccinations against these diseases are administered six times from infancy through age 12. The new review suggests adult boosters could be eliminated altogether, except in specific cases such as injuries requiring wound management.
The study compared vaccination policies and disease rates between France and the United Kingdom, two industrialized countries with similar childhood vaccination coverage. France continues adult booster vaccinations, while the UK has not recommended adult boosters beyond age 14 since the 1950s, except during pregnancy or for wound care. Despite decades of adult booster use in France, the review found no advantage over the UK in tetanus or diphtheria rates; the UK even showed a slightly lower rate overall.
In 2022, the UK experienced an outbreak of 73 imported diphtheria cases among asylum seekers, nearly matching the total diphtheria cases reported in the previous 20 years combined. However, no transmission was reported among other asylum seekers or healthcare workers, and the UK Health Security Agency concluded that the childhood-focused vaccination program remains sufficient to prevent disease spread and that the risk to the general population is low.
The findings underscore the durability of protection from childhood vaccination against tetanus and diphtheria, diseases that historically had high mortality rates—91% for tetanus and approximately 50% for diphtheria before vaccines and antibiotics. Today, thanks to vaccination programs, these diseases are extremely rare in the US.
Slifka emphasized, "Thanks to childhood vaccinations, these diseases are incredibly rare. In fact, you're 10 to 1,000 times more likely to be struck by lightning than to be diagnosed with tetanus and diphtheria in the United States."
Co-authors of the study include Archana Thomas and Lina Gao of OHSU; Ian J. Amanna of Najít Technologies; and Walter A. Orenstein of the Emory Vaccine Center. The research was supported by the National Institutes of Health.
