Tetanus is a rare disease in the United States, which predominantly affects the elderly and who have a lower prevalence of tetanus immunity compared with younger age groups. A large proportion of the elderly have not received primary immunization for tetanus and do not receive recommended tetanus booster immunizations. Although expert panels support immunization of all persons, without an upper age limit, physicians either are unaware of or do not act on recommendations to immunize the elderly. Improved education of physicians and patients, emphasizing a casefinding approach, may reduce the number of tetanus cases in the elderly. Studies are needed to find ways to improve tetanus immunity in the elderly.
(Arch Intern Med. 1991;151:1712-1717)