The seroepidemiological study’s purpose was to delineate Hangzhou’s immune status against tetanus and its influential factors in order to provide evidence for tetanus prevention strategies. Demographic information and vaccination histories for all subjects born between 2004 and 2018 were obtained from the Hangzhou Immunization Information System (HZIIS), while data for all subjects born prior to 2003 were obtained through case investigation. The study used an Enzyme Linked Immunosorbent Assay (ELISA) to detect tetanus IgG antibodies in serum samples, as well as univariate and multivariate analysis to look for a connection between tetanus IgG levels and other factors.

3695 subjects were included. About 59.84% of people had a strong history of tetanus-toxoid-containing vaccine immunisation (TTCVs). The geometric mean concentration (GMC) for tetanus IgG was 1.70 IU/ml, and the percentage of people with tetanus IgG antibody titers above the minimum protective level was 76.02%. People’s antibody levels were higher in rural areas than in urban areas, in males than in females.

Sex, age and history of immunisation in TTCVs have affected the positive rate and GMC of tetanus IgG significantly. Early and timely child vaccines should be achieved and the overall 3-Dose primary and 3-Dose Booster series before puberty should be highly covered. It is essential to emphasise the use in adolescents and adults of the booster dose vaccine of tetanus.