We thank Heiligman and Rousseau for their comments. Of course, tetanus immune globulin is indicated for seriously wounded patients in whom tetanus immunization is inadequate. A correction has already appeared (Arch Intern Med. 1991;151: 2451), but we believe that this is a serious enough matter to warrant another reminder. Heiligman is also correct in pointing out the other error.We agree with Rousseau that tetanus immunization is inadequate in the elderly and that physicians should incorporate inquiries about tetanus immunization into routine care. It is especially helpful to ask during health promotion activities, such as influenza vaccination.1 In this way, every physician who cares for elderly patients can lessen the incidence of this rare, but frequently fatal, disease.
Richardson JP, Knight AL. Tetanus in the Elderly-Reply. Arch Intern Med. 1992;152(8):1727. doi:10.1001/archinte.1992.00400200149037