Tetanus Vaccination Status and Anti-Tetanus Toxoid IgG Antibody Levels Among Medical Students: A Cross-Sectional Study
Hadi Ziya Kavaklılar, Kamile Marakoğlu, Esma Nakipoğlu, Salih MaçinBackground/Objectives: Tetanus is vaccine-preventable, and booster doses are essential for maintaining immunity. We assessed post-childhood tetanus vaccination status and anti-tetanus toxoid IgG levels among medical students and examined factors associated with each outcome. Methods: In this cross-sectional study, a stratified sample of 540 medical students was selected from 1497 medical students. Sociodemographic and vaccination data were collected by questionnaire. Self-reported vaccination data were cross-checked against vaccination cards and the Turkish national electronic health record system (e-Nabız) when records were available. Serum anti-tetanus toxoid IgG antibody levels were measured by enzyme-linked immunosorbent assay (ELISA). Years 1–3 were classified as preclinical years and Years 4–6 as clinical years. Results: Childhood vaccination completion was reported by 403 medical students (74.6%). Overall, 194 students (35.9%) reported receiving at least one tetanus-containing vaccine dose after 15 years of age. All medical students (100.0%) had seroprotective antibody levels. Students vaccinated after age 15 were older than those without vaccination after this age (22.73 ± 2.37 vs. 20.66 ± 1.65 years, p < 0.001). Post-childhood tetanus vaccination was more frequent among clinical-year than preclinical-year students (51.7% vs. 20.9%, p < 0.001). In unadjusted analyses, students in Years 5 and 6 had higher antibody levels than those in Years 1–4, and students vaccinated within the previous 5 years had higher levels than those vaccinated 6–10 years earlier (both p < 0.001). In multivariable analysis, age, rural residence, and clinical-year status were associated with post-childhood tetanus vaccination. Post-childhood dose category remained associated with IgG levels, whereas academic year and time since the most recent vaccination were not significantly associated with IgG levels after adjustment. Conclusions: Students vaccinated within the previous five years had higher serum anti-tetanus IgG levels than those vaccinated 6–10 years earlier. Comprehensive education on vaccination and immunization should be provided to medical students. Medical schools should encourage students to maintain their own immunity and serve as role models in promoting vaccination among their future patients.