Insufficient protection for healthy elderly adults by tetanus and TBE vaccines

Little information is available on post-vaccination antibody concentrations and the duration of protection in persons of more than 20 years of age. We, therefore, measured antibodies specific for tetanus (TT) or tick-borne encephalitis (TBE) virus in 734 adults (age 18–93 years, 382 females and 352 males) and evaluated these data in connection with the time point of the last vaccination against tetanus or TBE and age. This analysis revealed that the time of the last vaccination as well as age had highly significant effects on tetanus and TBE titers (p < 0.001). Our results show a strong decline in post-vaccination antibody concentrations with age, which sets in at the age of 40 in the case of tetanus, and is observed right throughout adult life in the case of TBE. Persons over 60 years of age frequently do not have protective antibody concentrations. We conclude that immunological responsiveness to vaccination decreases throughout adult life, and that conventional vaccination strategies designed for children and young adults cannot be uncritically applied in the elderly.