A population-based serologic survey of immunity to tetanus in the United States

Many adults and elderly people may not be adequately immunized against tetanus. Data from 10,618 people six years of age and older examined during the third National Health and Nutrition Examination Survey (NHANES) between 1988 and 1991 reveal that the percentage of people who are adequately immunized begins to drop substantially after the age of 40. Ninety-six percent of six-year-old children examined were adequately immunized, compared to 27.8% of those 70 years or older. Twenty percent of children aged 10 to 16 are not adequately immunized. A greater percentage of men were adequately protected longer, possibly because men have more accidents that require booster shots. The pattern of declining immunity was also present in blacks and Hispanics. A smaller percentage of the poor, uneducated and foreign-born had adequate protection against tetanus. Booster shots every 10 or 20 years may protect adults from tetanus.