Tetanus vaccination in adult population: coverage, registration and compliance

To ascertain correct tetanus vaccination coverage (CTVC), defined as any user who received the complete primary series of three adult doses of T or Td and/or up-to-date 10-yearly booster doses, with an official record thereof, among adults and assess percentage compliance with tetanus vaccination recommendation among the population lacking CTVC.

A total of 776 subjects took part, all of whom gave their consent. Mean age was 47.2 (SD: 20.2) years, and of the total 453 (58.4%) were women (p < 0.001). Overall CTVC was 71.6% (95% CI: 68.3-74.8), with the rate being lowest in the 35- to 45-year age group (59.8%) and 100% among the 14-year-olds. Of the 197 unvaccinated subjects, only 27 finally accepted vaccine recommendation.

The study was undertaken in two phases. Phase I: the prevalence of tetanus immunization was ascertained, using clinical interviews and examination of health records, in a representative sample of patients (> or = age 14 years) who sought emergency care at a 24-hour Medical Emergency Service in the Principality of Asturias (Spain) from April to May 2007. Phase II: a longitudinal prospective study was conducted in June 2007 on a subgroup of patients eligible for vaccination. Statistical significance was set at p < 0.05.

In Spain, adult immunization against tetanus is inadequate. A single dedicated register including all the different levels in the Health System and increase Health promotion education programmes would be necessary in order to reach the correct tetanus vaccination coverage.