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Open AccessArticle

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

1
Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 26042, Taiwan
2
School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
3
Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan
4
Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei 11221, Taiwan
5
Department of Family Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(8), 1622; https://doi.org/10.3390/ijerph15081622
Received: 1 July 2018 / Revised: 22 July 2018 / Accepted: 31 July 2018 / Published: 1 August 2018
(This article belongs to the Special Issue Vaccination and Health Outcomes)
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. View Full-Text
Keywords: tetanus boosters; vaccination coverage; extra-immunization; cohort study tetanus boosters; vaccination coverage; extra-immunization; cohort study
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Liu, S.-W.; Huang, L.-C.; Chung, W.-F.; Wu, J.; Chen, L.-F.; Chen, Y.-C. Tetanus Vaccination and Extra-Immunization among Adult Populations: Eight-Year Follow Up Cohort Study of 771,443 Adults in Taiwan, 2006–2013. Int. J. Environ. Res. Public Health 2018, 15, 1622.

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