When Eileen Carrier heads out to her garden this spring, she'll be thinking about soil conditions, planting arrangements and the usual details that take root in the minds of dedicated gardeners.

However, the Halifax resident will not be worried too much about nicking her green thumb on sharp gardening implements or other jagged objects hidden in the dirt, thanks to her decision to get a tetanus booster last year.

"I don't think many people pay much attention to it," says Carrier, 57, who has been gardening for at least 30 years.

"It had not crossed my mind until I was getting blood work done last fall and I was asked when was the last time I'd had a booster. They told me I need to have one every 10 years."

That was news to Carrier as it is to many other Canadian adults who believe they leave behind vaccination schedules once they reach adulthood.

But health experts say that like a well-tended garden, adults need to maintain their immunity to diseases like tetanus, diptheria and whooping cough.

According to Health Canada, the tetanus and diptheria booster should be given to adults every 10 years in a combined Td toxoid.

People also should be given a single dose of acellular pertussis vaccine during adulthood to make sure their protection against whooping cough is maintained.

Dr. David Allison of St. John's, N.L., co-chair of the Canadian Coalition for Immunization Awareness and Promotion, says Canada has done a good job with vaccinations overall.

He says tetanus, also known as lockjaw, is no longer a major health concern thanks largely to medical advances, vaccination programs and the fact that Canadians are much more urban than they were in the early part of the 20th century.

Fewer farmers, he says, means fewer tetanus cases.

"Between 1980 and 2004, the average number of cases was about four per year, and most of those in people over the age of 60," he says.

"There have been only about five deaths in that time period. It's not a deadly disease necessarily if it's identified early enough and treated appropriately."

Allison says that although a considerable number of people are unaware of tetanus boosters, he's pleased with the fact that many people do realize the need.

"About 50 per cent of adults 18 and over say they've had a tetanus shot in the last 10 years," he says. "That's quite a high proportion. Mind you, the numbers begin to drop off after age 65."

Tetanus is caused by a toxin produced by the bacteria Clostridium tetani. The bacteria, which is common in soil and animal feces, generally gains entrance to the body through a wound.

It paralyzes the muscles and central nervous system.

Symptoms like stiffness of the jaw and severe muscle spasms usually begin about eight days after infection but can take longer to appear.

Allison says the best prevention against tetanus is vaccination. Tetanus infections in fully immunized patients are exceptionally rare.

He says people also should be careful to thoroughly clean wounds.

He says that if an infection does take hold, antibiotics and a tetanus booster usually will clear up any problems.

Allison says Canada is fortunate in having a colder climate. He says tetanus is much more of a concern in warmer climates where the bacteria thrives in warm, moist soil.

"I wouldn't let fear of tetanus scare you from gardening," he says.

"Tetanus as a disease isn't that common in this country, partly because of our climate."