Vaccination of Adults and the Older Population against Tetanus, Diphtheria, Pertussis, and Tick-Borne Encephalitis: The Importance of Booster Vaccinations throughout Life.

Immunization strategies for the elderly are frequently perceived as comprising only vaccines against influenza, Streptococcus pneumoniae, and herpes zoster. However, besides these vaccines, which are recommended specifically for the elderly, regular booster vaccinations against tetanus, diphtheria, and in some cases pertussis and polio, are recommended in many countries for adults including the elderly. Vaccination recommendations for adults differ greatly between individual countries and coverage data are scarce. A substantial proportion of adults, and particularly of the older age groups, do not have protective antibody concentrations against diphtheria, whereas tetanus-specific antibody concentrations are generally higher. Protection against pertussis is unsatisfactory in all adults, and development of improved vaccines is ongoing. Future vaccination strategies should include regular and well-documented booster shots throughout life, as post-booster antibody concentrations correlate with pre-booster antibody concentrations.