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TETANUS IMMUNITY DECLINES WITH AGE.

Although nearly all school-age children receive at least three tetanus toxoid vaccinations, the actual rate of serologic immunity in children or adults is not well known. This American study identified segments of the U.S. population with increased susceptibility to tetanus infection. Researchers analyzed enzyme immunoassay data on serum taken from 10,618 persons age six or older who had been tested from 1988 to 1991. The overall immunity rate was about 70 percent, ranging from 88 percent in children ages 6 to 11, to 28 percent in people 70 years and older. The rate declined gradually until age 40, and then dropped sharply. Women proved slightly less likely to be immune than men (62 vs. 79 percent), and Mexican-Americans had a lower immunity rate (58 percent) than non-Hispanic whites (73 percent) and blacks (68 percent). Immunity rates also correlated with military service, educational status, and income. Comment: The true number of tetanus cases in the U.S. is probably about 100 to 150 annually, with about 10 to 20 deaths. The elderly account for most of these casualties, which are all theoretically preventable. One simple recommendation is to give a tetanus toxoid booster routinely at age 65 to patients who have completed a primary series.

— TL Schwenk

Published in Journal Watch General Medicine March 31, 1995

Citation(s):

Sanford JP. Tetanus -- forgotten but not gone. N Engl J Med 1995 Mar 23 332 812-813.

• Original article (Subscription may be required)
• Medline abstract (Free)

Gergen PJ, et al. A population-based serologic survey of immunity to tetanus in the United States. N Engl J Med 1995 Mar 23 332 761-766.

• Original article (Subscription may be required)
• Medline abstract (Free)