An unvaccinated 6-year-old child was hospitalized in Oregon for 57 days after contracting the state’s first case of tetanus in almost 30 years, ABC News reports.

The boy spent 47 days in the intensive care unit and 10 days in an intermediate care unit after being diagnosed with tetanus, leaving with a bill of almost $1 million in medical costs. ABC writes that “tetanus is caused by bacteria found in dirt that can enter the body through breaks in the skin, and vaccines are the best way to prevent it.”

The child got a cut while playing on a farm in 2017 and was treated at home. Six days after the Oregon boy was wounded, he had “episodes of crying, jaw clenching, and involuntary upper extremity muscle spasms,” had arching in his back and neck, and more spasms, according to a report written for the CDC's Morbidity and Mortality Weekly Report. He was diagnosed with tetanus when he rushed to a pediatric medical center by helicopter after he had trouble breathing. Doctors had to insert a tube in his trachea and a ventilator when his jaw muscle spasms prevented him from being able to drink water.

After his 57 days in the hospital, he was transferred to a rehab center for 17 days. He was able to resume his normal activities after another month. The family now owes the hospital $811,929 and another $11,143 for air transportation, rehab, and follow-up exams.

Tetanus cases have decreased by 95 percent and deaths by 99 percent since tetanus vaccines and tetanus immune globulin became widely used. The CDC recommends children receive the DTaP vaccine at 2 months old, 4 months, 6 months, 15 to 18 months, and then at 4 to 6 years old.

The boy’s family decided not to give him another DTaP vaccination “and any other recommended immunizations,” after his recovery from tetanus, according to the report.