title: Tetanus vaccination in adult population: coverage, registration and compliance.
abstract: OBJECTIVE
  To ascertain correct tetanus vaccination coverage (CTVC), defined as any user who received the complete primary series of three adult doses of T or Td and/or up-to-date 10-yearly booster doses, with an official record thereof, among adults and assess percentage compliance with tetanus vaccination recommendation among the population lacking CTVC.
  
  
  RESULTS
  A total of 776 subjects took part, all of whom gave their consent. Mean age was 47.2 (SD: 20.2) years, and of the total 453 (58.4%) were women (p < 0.001). Overall CTVC was 71.6% (95% CI: 68.3-74.8), with the rate being lowest in the 35- to 45-year age group (59.8%) and 100% among the 14-year-olds. Of the 197 unvaccinated subjects, only 27 finally accepted vaccine recommendation.
  
  
  METHODS
  The study was undertaken in two phases. Phase I: the prevalence of tetanus immunization was ascertained, using clinical interviews and examination of health records, in a representative sample of patients (> or = age 14 years) who sought emergency care at a 24-hour Medical Emergency Service in the Principality of Asturias (Spain) from April to May 2007. Phase II: a longitudinal prospective study was conducted in June 2007 on a subgroup of patients eligible for vaccination. Statistical significance was set at p < 0.05.
  
  
  CONCLUSIONS
  In Spain, adult immunization against tetanus is inadequate. A single dedicated register including all the different levels in the Health System and increase Health promotion education programmes would be necessary in order to reach the correct tetanus vaccination coverage.
authors.affiliation: El Coto Health Centre, Gijón, Asturian Regional Health Service, Principality of Asturias, Spain.
authors.forename: Moisés Robledo
authors.initials: MR
authors.lastname: del Corro
authors.forename: Mariana Isabel
authors.initials: MI
authors.lastname: Vargas-Román
authors.forename: Roberto Incio
authors.initials: RI
authors.lastname: García
authors.forename: Ruth Gil
authors.initials: RG
authors.lastname: Prieto
authors.forename: Angel Gil
authors.initials: AG
authors.lastname: de Miguel