Response to tetanus anatoxin vaccination in elderly women: prospective study during 42 months.

Objective - In developed countries, tetanus is mainly observed in senior ci tizens. The authors present a 42-month-long prospective study of the humora l immunity of elderly female patients. Patients and methods - One hundred and sixty elderly women (mean age: 84.5 years) admitted in a long-term care ward were immunized against tetanus by a first injection, a second one month after; and a booster injection one ye ar later. The humoral immunity was assessed by titration of tetanus antitox in antibodies by indirect hemagglutination. Results - Vaccination was well tolerated by all patients. Pre-vaccinal immu nity was satisfactory in 8%, unsatisfactory in 10%, and absent in 82% of th e subjects. Humoral response to immunization was globally satisfactory sinc e, after the booster injection, more than 90% of the nonimmune subjects aft er the first two injections exhibited seroconversion. However the antibody titer declined rapidly in more than half of the surviving patients at 30 an d 42 months. Factors related to a decrease of the cellular immunity, such a s the absence of hypersensitivity to tuberculin or a cancer; were associate d with a low reactivity to tetanus immunization in a statistically signific ant way. Conclusion - These results suggest that antitetanic vaccination should be p romoted in the elderly, and that booster injections should be given within a shorter time span. (C) 1999 Editions scientifiques et medicales Elsevier SAS.