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The Fourth of July is a time for fireworks, and also warnings about how fireworks are dangerous explosives to be handled carefully and definitely not after seven Miller Lites. But once upon a time—specifically, the dawn of the twentieth century—there was another associated worry: “Patriotic tetanus.”

That’s according to author Charles Richter, in a guest post for the blog of the National Museum of American History. He explains that, at the turn of the century, “Fireworks could cause a tetanus infection when they exploded on the [Clostridium tetani bacterium] spore-laden ground, sending showers of dirty shrapnel deep into the skin of bystanders.” As fireworks became increasingly popular and available, the result was—you guessed it—lots of tetanus.

By the late 19th century, fireworks became intimately linked with political campaigns and patriotic holidays. An industry had developed to supply political candidates and patriotic revelers with everything from hats and bunting to Roman candles and shotgun-launched exploding shells. As a relatively inexpensive entertainment, fireworks could enthrall large crowds with lots of bang for the buck. However, now that children and adults had easy access to miniature explosives, tetanus cases increased. These Independence Day infections were so common that they became known as “patriotic tetanus,” “Fourth of July tetanus,” or “patriotic lockjaw.”

Most of the cases were due to firing blanks, which were a popular amusement at the time.

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It got so bad that the American Medical Association began keeping track specifically of patriotic tetanus. In 1903, they reported 406 fatal cases. In fact, it was a bigger concern than outright blowing your hand off—Richter adds that from 1903 to 1909, “patriotic tetanus was responsible for almost two thirds of the 1,531 July Fourth explosives-related deaths.”

Fortunately, we no longer worry about this particular Independence Day danger due to the invention first of an antitoxin and then a vaccine that’s now a routine part of childhood shots. Chalk another one up for vaccines!