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. 2018 Aug 1;15(8):1622.
doi: 10.3390/ijerph15081622.

Tetanus Vaccination and Extra-Immunization among Adult Populations: Eight-Year Follow Up Cohort Study of 771,443 Adults in Taiwan, 2006⁻2013

Shih-Wei Liu  1 , Liang-Chung Huang  2 , Wu-Fu Chung  3   4 , Jauching Wu  4   5 , Li-Fu Chen  6   7 , Yu-Chun Chen  8   9   10
Affiliations

Tetanus Vaccination and Extra-Immunization among Adult Populations: Eight-Year Follow Up Cohort Study of 771,443 Adults in Taiwan, 2006⁻2013

Shih-Wei Liu et al. Int J Environ Res Public Health. .

Abstract

Under-and extra-immunization of tetanus boosters are important issues to consider in reducing the burden of vaccine-preventable disease in adults. The present study aimed to analyze the trend of vaccination coverage (VC) and risk factors associated with extra-immunization of tetanus during an 8-year period using a national-scale cohort database. Taiwan's one-million representative research database, the Longitudinal Health Insurance Database (LHID2005) was used. A total of 771,443 adults aged between 20 and 79 years were enrolled and followed from 1 January 2006 to 31 December 2013. VC at the beginning was as low as 35.1%, declining gradually and dropping to 33.9% at the end of follow-up. While a total of 303,480 tetanus boosters were used during the study period, more than half (55.5%) of these boosters were considered as extra-immunized. Both individual characteristics and visit characteristics were strongly associated with extra-immunization. Males, young and older adults, and those with a higher number of comorbidities were more likely to receive extra-immunization boosters, especially when they had more severe symptoms, visited an emergency room, or visited a hospital with lower accreditation levels located in a less urbanized area. This information could enhance implementation of evidence-based programs for tetanus boosters.

Keywords: cohort study; extra-immunization; tetanus boosters; vaccination coverage.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Interval change of immunity status against tetanus among adults aged between 20 and 79 years in Taiwan before and after 8-year follow up. (2006–2013; n = 771,443).
Figure 2
Figure 2
Tetanus vaccination coverage among adults aged between 20 and 79 years in Taiwan’s representative cohort at the beginning and the end of 8-year follow up by age and gender. (2006–2013, n = 771,443).
Figure 3
Figure 3
Predicted probability of receiving extra-immunized tetanus boosters and change from base probability by recipient demographics and visit characteristics among tetanus booster recipients aged between 20 and 79 years in Taiwan. (2006–2013; recipient number, 214,847; visit number, 303,480).
See this image and copyright information in PMC

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