Tetanus immunity in a selected Austrian population

Objective: In spite of the low morbidity secondary to tetanus, the high fat ality rate (about 50%) requires effective and extensive protection of the p opulation by vaccination. Since documentation is often lacking, booster tet anus vaccination is frequently applied in cases of minor injury. This leads to vaccination associated complications such as hyperergic reactions. The more intense the vaccination-associated side effects are, the less revaccin ation is possible. We investigated the tetanus immune status of a selected Austrian population. Materials and methods: Tetanus antitoxin antibodies were measured with ELIS A (Immunozym Tetanus, Immuno AG) in serum samples from 218 subjects who wer e hospitalised in a dermatology unit. In addition, patient history and data concerning vaccination were collected. Results: Based on the assumption that an antitoxin level of 0.1 IU/ml provi des sufficient protection, 63% of the subjects were found to be adequately protected. 56% showed high antibody concentrations above 0.5 IU/ml. However , the data also revealed no protection by vaccination in 37% of the subject s. Data obtained by case history or vaccination certificates could not serv e as a discrimination factor for applying revaccination or not. Conclusion: We strongly recommend better documentation of tetanus vaccinati on. In some cases, a search for tetanus antibodies before applying booster tetanus vaccination might be necessary.