Tetanus - Annual Epidemiological Report for 2023

Surveillance and monitoring
Publication series: Annual Epidemiological Report
Time period covered: This report is based on data for 2023 retrieved from EpiPulse Cases on 13 March 2025.
Cite:

European Centre for Disease Prevention and Control. Tetanus. In: ECDC. Annual epidemiological report for 2023. Stockholm: ECDC; 2025.

In 2023, 73 tetanus cases were reported in the European Union/European Economic Area (EU/EEA), of which 13 (18%) were confirmed cases.

  • The number of cases reported in 2023 (73) increased compared to previous years, after a decline from 69 cases in 2019 to 32 in 2020, followed by increases in 2021 (50 cases) and 2022 (53 cases).
  • Adults aged 65 years and above were the most affected age group, with women accounting for most cases.
  • In 2023, 13 fatal tetanus cases were reported (representing 21% of the 63 cases with a known outcome), mostly in women over 79 years old. This exceeds the annual number of fatalities reported in 2019–2022 (range: 5–11).
  • The current epidemiology in the EU/EEA may be explained by lower vaccination coverage or waning immunity among older populations.
  • The EU/EEA population-weighted average vaccination coverage for diphtheria tetanus toxoid and pertussis (DTP3) among one-year-olds slightly declined but remained high, reaching 92.8% in 2023 (94.3% in 2019, 93.4% in 2020, 93.6% in 2021, 93.4% in 2022).
  • Due to the severity of tetanus, there is a need to maintain high vaccination rates in all eligible age groups and to continue developing and implementing strategies to protect specific groups – particularly the elderly – in countries with higher rates of disease.