[Epidemiologic data for tetanus prophylaxis. Assessment of the need for vaccination]

In spite of the low morbidity secondary to tetanus, the high fatality rate (about 50%) requires effective and extensive protection of the population by vaccination. Since documentation is often lacking, booster tetanus 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 revaccination is possible. We investigated the tetanus immune status of a selected Austrian population.

Tetanus antitoxin antibodies were measured with ELISA (Immunozym Tetanus, Immuno AG) in serum samples from 218 subjects who were hospitalised in a dermatology unit. In addition, patient history and data concerning vaccination were collected.

Based on the assumption that an antitoxin level of 0.1 IU/ml provides 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 subjects. Data obtained by case history or vaccination certificates could not serve as a discrimination factor for applying revaccination or not.

We strongly recommend better documentation of tetanus vaccination. In some cases, a search for tetanus antibodies before applying booster tetanus vaccination might be necessary.