There’s only a few microbes in you initially. The shot helps you build immunity before the infection progresses too far.
However, tetanus bacteria is anaerobic. So for an advanced infection, they excise tissue all around the initial wound and the exposure to air kills the tetanus. This may be related to the old wives tale that wounds need to breathe to heal: a wound that would have given you what was once lethal tetanus wouldn’t if it got air.
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