Participation in a Voluntary Blood Donation Program as an Opportunity to Assess and Enhance Tetanus Immunity in Adult Blood Donors with an Outdated or Unknown Vaccination Status

Abstract

Background/Objectives: Booster vaccination coverage in the adult population in Poland remains insufficient. The objective of this study was to utilize the opportunity of a visit to the Regional Blood Transfusion Center in Wroclaw—associated with blood donation—as a means to remind individuals about the need for tetanus booster vaccination and to assess tetanus immunity in healthy adults (30–40 years after their last mandatory dose) who had not received booster immunizations. Materials and Methods: A total of 97 blood donors aged 50 to 64 years (median age: 54 years) were enrolled, of whom 78% were male. 1. Tetanus immunity was assessed by a single measurement of serum anti-tetanus IgG antibody concentration. 2. A questionnaire was used to collect data relevant to tetanus immune status. 3. Individuals with insufficient protection received a booster dose of the tetanus vaccine, and the post-vaccination serologic response was evaluated. Results: 1. In the study group, 10.3% of participants had no protective immunity against Clostridium tetani, while 5.2% exhibited uncertain protection. An additional 32% demonstrated antibody levels conferring only short-term protection. Satisfactory protection—defined as immunity lasting at least 3 years—or long-term protection (at least 5 years) was identified in 52.5% of patients. Although 72% of donors reported receiving mandatory childhood immunizations, only 5% could provide medical documentation. In this subgroup, a significantly higher geometric mean antibody concentration was observed (0.69 vs. 0.52 IU/mL; p = 0.04), and significantly fewer participants required immediate post-exposure prophylaxis (1/39 vs. 14/54; p = 0.003). 2. Among the 46 individuals eligible for a booster dose, 17 (37%) returned for vaccination. Of these, 16 (94%) achieved antibody titers consistent with long-term protection following a single vaccine dose. Conclusions: Tetanus immunity among adults is heterogeneous and difficult to predict due to the frequent lack of vaccination records and unreliable self-reported histories. A history of injury and associated surgical wound care involving injection often serves as the only indication of prior vaccination. A single booster dose is highly effective in eliciting a robust immune response in individuals vaccinated during childhood but lacking recent boosters. Rising vaccine hesitancy toward both mandatory and recommended immunizations in Poland negatively influences adult decisions regarding tetanus vaccination. Participation in voluntary blood donation programs presents a valuable opportunity for immunization education, immune status screening, and the implementation of effective catch-up vaccination strategies.