Seroprevalence of Tetanus Antibodies Among Adults Older Than 65 Years

Study objective: To define the extent of immunity against tetanus among patients older than 65 years of age by measuring antitetanus antibody levels. Methods: A convenience sample of 129 patients from an urban comprehensive care geriatric center was studied. Serum was obtained and enzyme-linked immunosorbent assay (ELISA) testing performed. Twenty health care providers, aged 25 to 40 years, were tested for comparison. Results: In 64 (50%) of 129 study patients, antitetanus antibody levels did not reach protective levels. Fifty-four (59%) of 92 women and 10 (27%) of 37 men did not have adequate titers. All 20 health care workers had protective titers. Conclusion: Elderly patients are substantially less likely than young individuals to have adequate immunity against tetanus. Emergency physicians must take this into consideration when evaluating tetanus immunization status in injured elderly patients. [Alagappan K, Rennie W, Kwiatkowski T, Falck J, Silverstone F, Silverman R: Seroprevalence of tetanus antibodies among adults older than 65 years. Ann Emerg Med July 1996;28:18-21.]