Investigation of the baseline tetanus antibody level and its persistence in a military unit.

• Tetanus booster immunization efficacy in Chinese army recruits was investigated. • One dose of the booster was calculated to maintain tetanus protection for 22 years. • The age of tetanus vaccination should be changed from 16 years to 20 years. • The booster interval should be changed from 10 years to 15 years. • The tetanus immunization strategy for army recruits should be adjusted accordingly. To determine tetanus antibody levels in army recruits and evaluate the persistence of immunity following tetanus booster immunization in adults. A total of 680 recruits were selected for observation of their tetanus antibody levels. From 2005 to 2015, 691 peacekeepers with tetanus vaccination were included in the questionnaire-based and serological survey based on cluster stratification. The tetanus antibody-positive rate, geometric mean concentration (GMC), and their respective changes over time were analyzed in different age groups, regions, and years after tetanus booster immunization. The positivity rates of tetanus antibodies in the recruits and peacekeepers were 74.85% and 99.86%, respectively (χ2 = 193.00, P < 0.05) and the antibody GMCs were 0.05 and 0.70 IU/mL (t = 15.73, P < 0.05). The antibody positivity rates of recruits from 12 provinces ranged from 47.62% (Hubei) to 100% (Inner Mongolia) (χ2 = 37.24, P < 0.05) and the antibody GMCs ranged from 0.02 (Hubei) to 0.09 IU/mL (Heilongjiang) (F = 5.19, P < 0.01). Among the 691 peacekeepers, no statistically significant difference in antibody positivity rate was detected between men and women. After administration of one booster dose of the tetanus vaccine, a protective antibody level was calculated to persist up to 22 years; a significant difference in antibody levels was observed within 10 years between one and two or more booster doses. The rate at which recruits tested positive for tetanus antibodies was low. Thus, it is necessary to screen for tetanus antibodies during military recruitment and implement a precision-based booster immunization protocol for tetanus vaccine. Moreover, one dose of the tetanus vaccine booster has been calculated to maintain a protective antibody level up to 22 years, without the need for repeated reinforcements during this period. [ABSTRACT FROM AUTHOR]