Ojectives: Tetanus is a neurologic disorder which occurs as sporadic cases in people with incomplete vaccination course.The most tetanus patients are people over 60 years of age.It is a important disease in elderly patients because of risk of severe forms and high rate of morbidity and mortality This study was conducted to evaluate tetanus immunity in 50 years of age and older people in kashan-Iran.

Methods & Materials: This cross-sectional survey was conducted on 180 randomly selected adults, 50 years of age and older who visited Booali laboratory for check up examination in kashan -Iran in 2008.After taking consent form standard questionnaires consisting demographic data and history of vaccination were filled and 5cc blood taken from selected persons and tetanus toxoid-specific antibody were measured by ELISA method .Results were analyzed by SPSS and presented by descriptive statistics.

Results: Sixty five per cent of adults 50 years of age and olderhad no protective levels of tetanus antitoxin (<0.1 IU/mL). Overall, 180 persons were included. Of these, 72(40%) had never received a toxoid booster, while 47(26.1%) had received a booster at least once. Among 86 participants aged>60 years, 6(7%) had protective antitoxin levels IU/mL 0.1-1, and 5(5.8%) had protective antitoxin levels  IU/mL≥1. Male gender and prior receipt of toxoid booster(s) wereassociated with protective tetanus immunity. Tetanus antitoxin levels declined with age.

Conclusion: It appears that most 50 years of age and older adults do not have protective levels of tetanus antitoxin because of inadequate vaccination coverage. There is a need to improve the immunity levels of this age group.