Doses Of Tetanus Toxoid Vaccine Research Articles

Multilevel and subnational analysis of the predictors of maternity continuum of care completion in Nigeria: a cross-sectional survey

Understanding population discrepancy in maternity continuum of care (CoC) completion, particularly in sub-Saharan Africa is significant for interventional plan to achieve optimal pregnancy outcome and child survival. This study thus investigated the magnitudes, distribution, and drivers of maternity CoC completion in Nigeria. A secondary analysis of 19,474 reproductive age (15–49 years) women with at least a birth (level 1) in 1400 communities (level 2) across 37 states covered in the 2018 cross-sectional survey. Stepwise regression initially identified important variables at 10% cutoff point. Multilevel analysis was performed to determine the likelihood and significance of individual and community factors. Intra-cluster correlation assessed the degree of clustering and deviance statistics identified the optimal model. Only 6.5% of the women completed the CoC. Completion rate is significantly different between communities “4.3% in urban and 2.2% in rural” (χ2 = 392.42, p < 0.001) and was higher in southern subnational than the north. Education (AOR = 1.61, 95% CI 1.20–2.16), wealth (AOR = 1.73, 95% CI 1.35–2.46), media exposure (AOR = 1.22, 95% CI 1.06–1.40), women deciding own health (AOR = 1.37, 95% CI 1.13–1.66), taking iron drug (AOR = 1.84, 95% CI 1.43–2.35) and at least 2 dose of tetanus-toxoid vaccine during pregnancy (AOR = 1.35, 95% CI 1.02–1.78) are associated individual factors. Rural residency (AOR = 1.84, 95% CI = 1.43–2.35), region (AOR = 1.84, 95% CI 1.43–2.35) and rural population proportion (AOR = 1.84, 95% CI 1.43–2.35) are community predictors of the CoC completion. About 63.2% of the total variation in CoC completion was explained by the community predictors. Magnitude of maternity CoC completion is generally low and below the recommended level in Nigeria. Completion rate in urban is twice rural and more likely in the southern than northern subnational. Women residence and region are harmful and beneficial community drivers respectively. Strengthening women health autonomy, sensitization, and education programs particularly in the rural north are essential to curtail the community disparity and optimize maternity CoC practice.

Tetanus Toxoid Vaccination Status of Women in Baghdad

Background: Immunization remains one of the paramount public health interventions and a cost effective method to reduce both the ailment and death associated with infectious diseases. Uptake of vaccination is dependent not only on providing of the vaccination services but also on other influences including awareness and practice of women. Objectives: To assess tetanus toxoid immunization status of mother’s. In addition, to address the factors influencing their immunization status. Method: Cross sectional study conducted in ten primary health care centers in Baghdad for the period from February until the end of October 2020. Convenient sample of mothers, who had delivered a live baby within the previous 12 months from the study and attended the selected primary health care centers in Baghdad were recruited. An interview questionnaire used to collect data regarding history of tetanus toxoid vaccine up take of the mothers during their last pregnancy. Results: The total number of mothers enrolled in the study was 400, 214(53.5%) of them were received tetanus toxoid vaccine (TTV) during their last pregnancy. 127(59.3%) of the mothers were uptake two doses of TTV. Among the study group, 31.75% of mothers were considered as immunized according to WHO classification. Age of mother, education, and respondents’ working status; alongside with antenatal care attendance and place of delivery all had insignificant impact on the immunization status. Lack of time was the main reason for not vaccination (22.6%). Conclusion: Tetanus toxoid immunization coverage was inadequate. For that reason, immunization campaigns targeting enhanced utilization of immunization services by mothers and women of childbearing age are highly recommended.

Tetanus vaccine coverage in recommended and more than recommended doses among mothers in a West Cameroon health district: a cross sectional study

Background: Vaccination is the best way to protect newborns and mothers against tetanus. The number of doses of Td vaccine recommended by the Expanded Program of Immunization is based on documented protective immune response. During this decade, the Foumban Health District (FHD) was the seat of an epidemic despite the satisfactory administrative immunization coverage. This study was conducted in 2019 in the FHD to assess tetanus vaccine coverage among mothers for their last pregnancy and the cumulative number of vaccine doses administered to the mothers. Method: This was a descriptive cross-sectional study conducted in the FHD in 2019. Mothers living in the district with at least one child younger than five years were included and were selected by random stratified cluster sampling. Trained surveyors used a face-to-face questionnaire, data extraction grid and data-tracking grid to review and collect data from antenatal care booklets, vaccination cards and the women’s own reports of immunization. The immunization coverage per vaccine dose and vaccination completeness rate were estimated. Results: From 621 women visited, 602 (96.9%) responded. A total of 176/511 women (34.4%) had evidence of vaccination. For the last pregnancy, the two-dose immunization proportion was 21.7% (111/511) for documented coverage and 47.6% (243/511) for undocumented coverage. 306/570 women (53.7%) had received more than the recommended five doses necessary for lifetime protection. The recruitment, two and five doses completeness rates were 99.9% (569/570), 95.8% (546/570) and 65.3% (372/570), respectively. Conclusion: More than half of mothers received more doses of tetanus toxoid vaccine than necessary in FHD. This increased the resources needed and the cost of vaccination. Health personnel should be trained and supervised to assess pregnant women’s vaccination status before planning the number of vaccine doses to be administered during pregnancy.

Tetanus vaccine coverage in recommended and more than recommended doses among mothers in a West Cameroon health district: a cross sectional study

Background: Vaccination is the best way to protect newborns and mothers against tetanus. The number of doses recommended by the Expanded Program of Immunization is based on documented protective immune response. This study was conducted in 2019 in the Foumban Health District (FHD) to assess tetanus vaccine coverage among mothers for their last pregnancy and the cumulative number of vaccine doses administered to the mothers. Method: This was a descriptive cross-sectional study conducted in the FHD. Mothers living in the district with at least one child younger than five years were included and were selected by random stratified cluster sampling. Trained surveyors used a face-to-face questionnaire, data extraction grid and data-tracking grid to review and collect data from antenatal care booklets, vaccination cards and the women’s own reports of immunization. The immunization coverage per vaccine dose and vaccination completeness rate were estimated. Results: From 621 women visited, 602 (96.9%) responded. A total of 176/511 women (34.4%) had evidence of vaccination. For the last pregnancy, the two-dose immunization proportion was 21.7% (111/511) for documented coverage and 47.6% (243/511) for undocumented coverage. 306/570 women (53.7%) had received more than the recommended five doses necessary for lifetime protection. The recruitment, two and five doses completeness rates were 99.9% (569/570), 95.8% (546/570) and 65.3% (372/570), respectively. Conclusion: More than half of mothers received more doses of tetanus toxoid vaccine than necessary in FHD. This increased the resources needed and the cost of vaccination. Health personnel should be trained and supervised to assess pregnant women’s vaccination status before planning the number of vaccine doses to be administered during pregnancy.

Increasing Frequency of Antenatal Care Visits May Improve Tetanus Toxoid Vaccination Coverage in Pregnant Women in Pakistan

ABSTRACT Objective Maternal and neonatal tetanus (MNT) elimination in low-income countries is a major aim of public health endeavors, due to poor vaccination status, lack of antenatal care, and unhygienic birth practices. The objective of this study, thus, was to assess the present state and factors associated with maternal tetanus toxoid (TT) vaccination in Pakistan. Methods Overall, 80 pregnant women (26 ± 4 y) during their last trimester were recruited from the district hospital Khanewal, Pakistan. The prevalence of vaccination was ascertained through clinical interviews and examination of health records from each participant. A questionnaire-based interview was conducted to assess the education level, antenatal visits, and sociodemographic variables related to vaccination coverage. A generalized linear model was used for statistical analyses. Results Seventy-nine percent of pregnant women were vaccinated with two doses of TT vaccine, while 16% of women were unvaccinated. Overall, 66% of pregnant women received two or more antenatal visits. Two and more than two antenatal visits during pregnancy were associated with significantly increased odds ratios for sufficient TT vaccination (OR = 1.60, CI [95%] 1.34–1.92 and OR = 1.61, CI [95%] 1.32–1.97, respectively) as compared to no or only one antenatal visit. Conclusion Regular antenatal care can improve vaccination coverage during pregnancy. Hence, reducing barriers for visiting antenatal care facilities could be key to reach the goal for MNT elimination.

Determinants of Noncompletion of the Third Dose of Tetanus Toxoid Vaccine in Pregnant Women in Dschang Health District, Cameroon.

Introduction. Tetanus vaccination plays an important role in the fight against neonatal mortality. Our study aimed to determine the noncompletion rate of the 3rd dose of tetanus toxoid vaccine (TTV) and to analyze the associated factors in pregnant women. Methods This was a cross-sectional study conducted in 2 hospitals of Dschang Health District and targeting all women at least in their second gestation coming for antenatal consultation. Upon informed consent by the participant, a prepared questionnaire was administered. The collected data was analyzed using SPSS v22.0 with results presented in means and proportions. Logistic regression was used at two levels to identify independently associated factors for noncompletion of the third dose of TTV with a significance set at 5%. Results A total of 380 pregnant women were recruited in this study of mean age 27 ± 5.2 yrs, 70% being married, more than 80% having at least secondary education, and 31.8% of them being students. It was noted that 172 (45.26%) of these women had not received the third dose of TTV. The analysis of the adjusted effects showed that not going to postnatal consultation (aOR = 6.75; 3.98–11.49, p < 0.0001), not accompanying her baby to vaccination (aOR = 3.784; 1.803–7.942, p < 0.0001), not accompanying her baby to vaccination (aOR = 3.784; 1.803–7.942, p < 0.0001), not accompanying her baby to vaccination (aOR = 3.784; 1.803–7.942, Conclusion Tetanus vaccination coverage is not yet optimal in Dschang Health District and is associated with marital status as well as postgestational behavior of the mothers. There is thus the need to put in place strategies that will provide social support to single mothers as well as encourage women to attend postnatal consultation and to accompany their own children for vaccination. Furthermore, community-based vaccination could capture some of the lost women thus optimizing the overall vaccination coverage.

Tetanus Toxoid Status and Determinants of Uptake among Women in Etche Local Government Area, Rivers State, Nigeria: A Community Based Study

Introduction: Nigeria is one of the countries where maternal and neonatal tetanus is still prevalent and as such a public health issue. In spite of campaign on maternal tetanus immunization, its safety and protection against tetanus, uptake has remained poor.&#x0D; Aim: This study is aimed to determine the level of Tetanus Toxoid (TT) vaccine uptake among women of child bearing age in Rivers State Nigeria.&#x0D; Methods: Using a cluster sampling method, a descriptive cross-sectional community based study was carried out. The study was carried out in Opiro community in Igbo Agwuru-Asa Clan in Etche Local Government Area of Rivers State.&#x0D; Results: Of the 555 women studied 108(19.5%) of them had received 5 doses of TT while 206 (37.1%) had received at least two doses of TT, giving an overall prevalence of TT utilization among women of childbearing age of 31.7%. Eighty four (31.2%) of women who were ≤ 30 years compared to the 122(42.7%) of the older women had received at least 2 doses of TT vaccine. This was statistically significant (P=0.005, OR 1.67, 95% CI 1.16-2.32), educational level, marital status and occupation also significantly affected Tetanus Toxoid vaccine uptake among the women.&#x0D; Conclusion: This study concludes that utilization of TT immunization among women is low, that younger age, marital status, level of education and occupation of the women can significantly affect the level of TT uptake among women. There is need to strengthen immunization in this community and to create awareness on the need to get optimal Tetanus Toxoid immunization.

Knowledge, attitude and practices of reproductive age females about tetanus toxoid vaccine: a pilot study.

Tetanus is a non-communicable infectious disease caused by bacterium Clostridium tetani. Maternal tetanus can occur during pregnancy or within 6 weeks after termination of pregnancy. Women are prone to tetanus while giving birth under unhygienic delivery conditions and low TT (tetanus toxoid) immunization. These conditions put their newborn babies at risk for neonatal tetanus (NNT) which is defined as tetanus occurring in the newborn within 28 days after birth. Pakistan is one of the five countries accounting for 90% of global NNT deaths. The percentage of women receiving two doses of TT vaccine in Pakistan was 56% in 2002 57% in 2003 and 45% in 2004. There is a need to discover reasons for low TT immunization coverage among females of Pakistan. One reason is demand failure as people do not demand or use immunization due to lack of knowledge about its benefits to them. There is little published data that reveals the knowledge of Pakistani females of reproductive age about the benefits of TT vaccine. This study aimed to estimate the knowledge attitude and practices of reproductive age females about TT vaccine and to find out means to improve TT vaccine outreach to them. (excerpt)

An exploratory study on knowledge and practice regarding family planning and immunization among women attending MCH clinic

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Globally, an estimated 300,000 maternal deaths occur annually owing to causes associated with pregnancy, of which nearly 75% were preventable. Each year, modern contraceptives help women prevent 215,000 pregnancy-related deaths (including 66,000 from unsafe abortions), 2.7 million infant deaths and the loss of 60 million years of healthy life. Vaccination is one of the most cost-effective health interventions available, saving millions of children from illness, disability and death each year. The burden of infectious diseases has been reduced primary due to immunization.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A cross-sectional study regarding knowledge and practice of family planning and immunization was conducted in a Maternal and Child health (MCH) clinic of Western Regional Hospital, Pokhara. The sample consists of 100 married women of reproductive age group (15-49) years having under five children coming to the clinic using purposive sampling technique. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Knowledge regarding family planning methods were oral contraceptive pills/depot/implant (84%) followed by intrauterine contraceptive device (77%), condom (65%), natural methods (80%), permanent method (92%). Condom was most commonly used among temporary methods. More than 4/5&lt;sup&gt;th&lt;/sup&gt; of the respondents were aware about vaccines as per schedule of Nepal. But 5% of the respondents had neither given any vaccine to their baby and nor taken any dose of tetanus toxoid vaccine during their previous pregnancy.&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Still 14% of the respondents were not aware about any methods of family planning and 19% does not know about the vaccines as per schedule of Nepal. So there is a need to increase awareness about the different types of family planning methods and immunization.

Predictors of Neonatal Tetanus Mortality in Katsina State, Northwestern Nigeria.

Background:The mortality rate of neonatal tetanus (NNT) remains high in Nigeria. The study was guided by Mosley and Chen’s model for the elements of child survival in developing countries. The goal of the study was to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and cord care with neonatal mortality as the outcome variable.Methods:The study is a retrospective record review using data from 332 NNT records and analyzed using a logistic regression model.Findings:Neonates whose mothers had 1 dose of tetanus toxoid vaccine were found to be 4% less prone to NNT mortality compared to neonates whose mothers did not have any dose of tetanus toxoid vaccine during pregnancy (P < .05, odds ratio = 4.12, 95% confidence interval = 1.04-16.29. Frequency of antenatal visits, place of delivery, and cord care were all not significant predictors of NNT mortality.Conclusion:The study shows that there is association between NNT risk factors and neonatal mortality, hence the need to further strengthen the NNT surveillance system for early detection of potential risk factors. This would help develop specific public health interventions aimed at improving the outcome of NNT.Implications:The identification and analysis of NNT mortality risk factors and promoting tetanus toxoid vaccination among pregnant women are effective strategies toward attaining NNT elimination goals in Nigeria.

Awareness and Status of Tetanus Toxoid Vaccination among Female Undergraduate Students in a Nigerian University

Aims: The study aimed to determine the level of awareness and status of tetanus toxoid (TT) vaccination among female undergraduates in Port Harcourt. Study Design: This was a cross sectional descriptive study carried out among female undergraduate students. Place and Duration of Study: The study was carried out in University of Port Harcourt from 1 to 31 st of May 2014. Methodology: A pre-tested questionnaire was administered to 512 female students selected through a Multi-Staged sampling technique. Information sought included socio-demographics, Original Research Article Alex-Hart and Okoh; IJTDH, 7(1): 6-15, 2015; Article no.IJTDH.2015.052 7 awareness of TT vaccine, knowledge of the vaccination campaign for women of childbearing age and TT vaccination status. Data was analyzed using epi info version 7.1.3.3. Results: A total of 512 students participated in the study; mean age was 22±2.79 years. Four hundred and eighty five (94.7%) and 409 (79.9%) students had heard of tetanus and TT vaccine respectively. Commonest sources of information were health workers. 33.8% knew the target population for the TT vaccination campaign and 18.2% knew that the correct number of doses of TT is 5 doses. Two hundred and ninety eight (58.2%) and 10 (2%) students had received at least 1 dose and 5 doses of TT respectively. Students who had knowledge of the target population for TT vaccination campaign (OR=2.14, p=0.003) and those who were confident in the effectiveness of TT (OR=2.41, p<0.001) were twice more likely to receive at least a dose of TT vaccine. Conclusion: There was poor knowledge of TT vaccination campaign for women of childbearing age and very poor coverage of TT5 among the female undergraduate students in Port Harcourt. Female undergraduate students should be reached during TT vaccination campaigns.

A systematic review of tetanus in individuals with previous tetanus toxoid immunization.

To assess the characteristics of tetanus in previously immunized individuals. A systematic literature search was undertaken using Ovid MEDLINE(R) and EMBASE databases for articles published between 1946 and September 3, 2013. The search strategy was developed using MESH terms for "tetanus", "immunization" and "vaccination". Inclusion criteria were articles in English or French that described at least one case of tetanus, immunization history and/or the results of anti-tetanus antibodies. Articles were reviewed for relevant references. 51 unique articles published from1946-2013 were included in the review. The articles described 359 cases of clinical tetanus in individuals with prior receipt of one or more doses of tetanus toxoid vaccine and/or levels of tetanus antibody titres generally considered protective. Of the 210 cases that reported patient status at discharge, 180 (85.7%) survived with only three cases reporting residual deficits. Tetanus spores are ubiquitous and this report clearly documents that tetanus cases can occur in individuals previously immunized with tetanus toxoid vaccine. Clinicians should not rule out tetanus when clinical symptoms suggest it, regardless of the vaccination history. When treated, the prognosis for tetanus is good. Further research is needed to assess the incidence of tetanus in partially- and fully-immunized populations and determine whether this is due to waning immunity of vaccine failure.

Neonatal Tetanus in Federal Medical Center, Ido-Ekiti, South West Nigeria in a five year Retrospective Study

Introduction: Neonatal Tetanus, though a preventable disease through simple measures, still remains a cause of neonatal mortality in Nigeria. Methodology: This was a review of all cases of neonatal tetanus in Federal Medical Centre, Ido- Ekiti between January 2007 and December 2012. It was performed using patients’ case notes and the diagnosis of tetanus was clinical in all cases. Results: There were six patients admitted during the five- year period. The mean age was 7.7 days. There were 5 females (83.3%) and 1 male (16.7%). The average number of days spent on admission in the hospital was 15.2 days with the minimum being 1 day and the maximum 33 days. The mean age at which the first spasm occurred was at 7.5 days. Only 1 (16.7%) was delivered in a health facility, 67.7% had fomentation done on their umbilical cords, 33.3% had septic umbilical cords only 1 (16.7%) was delivered in a health facility. Three of the patients were delivered in religious centres called mission homes. Five (83.3%) of the mothers were teenagers and unmarried, 2 (33.3%) had partial antenatal care, 4 (67.7%) had no antenatal care while none of them received up to 2 doses of tetanus toxoid vaccine. The case fatality rate was 50%. Conclusion: Teenage motherhood, poor antenatal care, inadequate immunization of mothers with tetanus toxoid vaccine and poor umbilical cord care are identified as risk factors for neonatal tetanus. It should be ensured that gender equality campaigns are strengthened, traditional birth attendants trained in issues of maternal and child health, and immunization campaigns for mothers and neonates improved.

Impairment of humoral and cellular immune response to tetanus toxoid in HTLV-1 infected individuals

The human T cell lymphotropic virus type-1 (HTLV-1) infect mainly T cells, dendritic cells and macrophages inducing T cell proliferation and increasing production of chemokines and cytokines by peripheral blood mononuclear cells (PBMC). However, as HTVL-1 may modify the immune response to other infectious agents, the aim of this study was to evaluate the humoral and cellular immune response before and after vaccination with tetanus toxoid (TT). Participants included 14 HTLV-1 carriers and 12 healthy subjects (HS). These individuals were immunized with two doses of tetanus toxoid vaccine. Antibodies to TT were determined by ELISA and the frequency of T cells expressing cytokines as well as the frequency of monocytes expressing co-stimulatory molecules were determined by FACS. The IgG titers anti-TT increased after immunization in both groups (p = 0.001), but HTLV-1 patients had lower levels of IgG anti-TT after immunization when compared with HS (p = 0.007). The frequency of CD4+ T cells expressing IFN-g, TNF and IL-10, after stimulation with TT, was lower in HTLV-1 infected subjects than the HS after immunization (p < 0.05). TNF and IL-12 expression by monocytes after stimulation with TT were higher in the HTLV-1 group than in HS. However there was an impairment in the HLA-DR expression by monocytes from HTLV-1 infected subjects. These results indicate that HTLV-1 infected subjects have a decreasing in humoral response and an impairment in both antigen presenting cells and T cell functions to a biased antigen. Financial Support: INCT-DT, CNPq, NIH R01.

Seroprevalence of Anti-tetanus Antibodies in Women attending Omdurman Maternity Antenatal Clinic in Sudan

Seroprevalence of Anti-tetanus Antibodies in Women attending Omdurman Maternity Antenatal Clinic in Sudan

Prevention of meningococcal serogroup C disease by NeisVac-C™

NeisVac-C™ has been demonstrated to be safe, immunogenic and efficacious when administered to infants, toddlers, older children and adults. It is one of the licensed meningococcal serogroup C conjugate vaccines and a single dose in infancy may be sufficient for protection until a booster dose is given in the second year of life. Persistence of serum bactericidal antibody, rather than immune memory, is now known to be a more appropriate correlate of long-term protection for serogroup C meningococcal disease. NeisVac-C was demonstrated to enhance responses to Haemophilus influenzae type b (Hib) polyribosylribitol phosphate when coadministered with Hib–tetanus toxoid conjugate vaccines. NeisVac-C also enhances tetanus toxid responses and a dose of NeisVac-C in older children induces responses similar to a dose of tetanus toxoid vaccine.

Tetanus in developing countries: an update on the Maternal and Neonatal Tetanus Elimination Initiative

Tetanus is a vaccine-preventable disease that yearly causes a total of 309,000 deaths. Of particular concern is maternal and neonatal tetanus (MNT), which can be prevented through immunization of the mother in pregnancy. In 2000, neonatal tetanus alone was responsible for an estimated 200,000 deaths. While the focus is on 57 priority countries, 90% of the neonatal tetanus deaths occur in 27 countries. UNICEF is spearheading the effort to eliminate MNT by the year 2005, with the support of numerous partners. MNT elimination is defined as less than one case of neonatal tetanus per 1000 live births at district level. The main strategies consist of promotion of clean delivery practices, immunization of women with a tetanus toxoid (TT) containing vaccine, and surveillance. Maternal tetanus immunization is, in most developing countries, implemented as part of the routine immunization program. However, large areas remain underserved, due to logistical, cultural, economical or other reasons. In order to achieve the target of MNT elimination by 2005, and to offer protection to women and children otherwise deprived from regular immunization services, countries are encouraged to adopt the “high risk approach”. This approach implies that, in addition to routine immunization of pregnant women, all women of child bearing age living in high risk areas are targeted for immunization with three doses of a tetanus toxoid containing vaccine (TT or Td), implemented as “supplemental immunization activities” (SIAs). Through SIAs, about 17 million women have been reached with at least two doses of TT vaccine in the past 3 years, and it is estimated that another 200 million need to be targeted in the years to come. SIAs should substantially reduce the burden of disease. Countries will also have to improve their existing immunization and clean delivery programs to ensure that the elimination of maternal and neonatal tetanus is maintained.

Immunologic Response to a Single Dose of Tetanus Toxoid in Older People

Several studies have demonstrated that a large percentage of older people are inadequately immunized against tetanus. The aim of this study was to assess the immunity against tetanus in a group of individuals aged 69 and older and to examine the immune response to a single dose of tetanus toxoid. A convenience sample of 115 residents of a large retirement home, aged 69 and older, was studied. After a blood sample for anti-tetanus antibody titer, a single dose of tetanus toxoid vaccine was administered. Repeat titers were obtained 6 weeks after the vaccination and analyzed by ELISA assay. Antibody levels equal to or greater than 0.1 IU/mL were considered protective. Sixty-seven of 115 (58.3%) individuals had adequate antibody titers. Those individuals who reported having been vaccinated with tetanus toxoid in the past were more likely to be immunized adequately compared with those who reported having never been vaccinated (66.7% vs 39.3%, P = .02). After vaccination, 34 of 46 (73.9%) individuals with inadequate antibody titers became seropositive. Those who remained seronegative had mean prevaccination antibody titers significantly lower than those who seroconverted. Sixteen of 17 (94.1%) persons who reported having been vaccinated in the past and were found to be seronegative developed adequate antibody titers following vaccination, compared with only nine of 16 (56.2%) who reported never having been vaccinated (P = .04). There was no association between seroconversion rate and age, sex, underlying diseases, and army service. Most individuals will develop an adequate anti-tetanus antibody titer following administration of a single dose of tetanus vaccine. A history of past immunization is a good predictor of becoming adequately immunized. It is important that physicians follow the current recommendations for adult immunization and initiate campaigns to ensure that the older population is protected against tetanus.