Tetanus, a disease caused by the neurotoxin-producing bacteria Clostridium tetani (C. tetani), remains a serious threat, particularly among individuals who are unvaccinated or under-vaccinated. Although public health guidelines in the United States continue to recommend a well-established, multi-dose vaccination schedule to prevent tetanus, recent revisions to the Centers for Disease Control and Prevention webpage language on vaccine safety prompted renewed public discussion. Despite this, extensive evidence continues to demonstrate the effectiveness and safety of tetanus immunization, and certain demographic groups remain disproportionately at risk. Globally and within the United States, natural disaster zones remain especially high-risk environments for tetanus infection. This review examines the pathophysiology of tetanus, current vaccination recommendations, and the social and geographic inequities that influence vaccine uptake. It also evaluates strategies of protection and prevention. Particular emphasis is placed on tetanus risk in disaster settings, where disrupted infrastructure, greater likelihood of contaminated wounds, and preexisting disparities in vaccination coverage compound vulnerability. A clearer understanding of these factors is essential for strengthening public health preparedness and ensuring equitable protection against tetanus, especially for populations disproportionately affected by disasters.