Evaluation for Tetanus Antibodies in Korean-Americans Living in the New York Area: A Pilot Study

Abstract

Public health initiatives to immunize children and adults have effectively reduced the number of tetanus cases in the USA. However, in the third National Health and Nutrition Examination Survey (NHANES III), immigrants from Mexico had a 67% non-protective anti-tetanus antibody (ATA) level. Less work has been conducted among other immigrant populations to determine the extent of this observation. Objective To measure ATA levels among the Korean-American immigrant population. Methods A convenience sample of 50 Korean Americans born outside the USA was recruited to determine the levels of ATA. A non-protective level of ATA was defined as below 0.15 IU/ml. Results The mean age was 59.5 years and 82% were female. There were 43/50 (86% (95% confidence limits 76, 96)) patients with a non-protective ATA level. Those between the ages of 50-59 years (94% were seronegative) and 60 years-highest age (92% were seronegative) were among the least likely to be protected. Neither gender nor a self-reported history of past tetanus immunization or military service predicted protection to tetanus. Discussion In this pilot study we found that 86% of Korean immigrants did not have protective ATA levels, with patients in the 50-59 year age range as unlikely to be protected as the older subjects. Patient reported history was unreliable in determining whether an individual had protective levels. Conclusion The vast majority of sampled Korean American immigrants lack protective ATA levels and are in need of immunization. Additional study is needed to determine the risk of other immigrant groups to tetanus.