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Thanks to pediatric vaccination programs, Oregon hadn’t had a case of childhood tetanus in 30 years. That changed in 2017, when an unvaccinated 6-year-old boy spent weeks in the ICU and amassed an $800,000 medical bill after contracting the infection, according to a recent case study by the CDC.

A Washington Post story reports the boy was playing on a farm and cut his head. His parents chose to stitch the cut at home, and six days later, he was airlifted to a hospital with the telltale symptoms of tetanus: clenched jaw, arched back and muscle spasms.

The two months that followed sound almost incomprehensibly traumatic and painful. His spasms worsened and doctors had to intubate in order for the child to breathe, ultimately inserting a tube connected to a ventilator into his windpipe. He was confined to a dark room with ear plugs in order to reduce the spasms, which was probably absolutely terrifying to a first grader on top the pain he must have been experiencing. All told, the boy spent 47 days in the ICU on neuromuscular-blocking drugs to treat the spasms. He was also given the DTaP vaccine for protection against diphtheria, tetanus and pertussis.

The CDC puts the final bill for the ICU stay at $811,929, though that number doesn’t include the cost of airlifting or the two weeks he spent at a pediatric rehabilitation facility.  

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The Post report five rounds of the DTaP vaccine at $30 apiece would have prevented the infection. However, when physicians recommended that the boy be brought up to date on all his vaccines, along with receiving a follow-up round of DTaP, the family declined.