Analysis of characteristics of patients with delayed or incomplete tetanus vaccination after trauma at Zhejiang hospital

Objective To investigate the epidemiological characteristics of tetanus vaccination and injury types among patients with animal-related injuries, traffic accident injuries, sharp instrument injuries, blunt injuries, and other injuries at Zhejiang Hospital, based on the emergency surgery medical records and treatment data, so as to provide a preliminary basis and recommendations for subsequent tetanus vaccination practice. Methods A single-center retrospective cross-sectional study was conducted. Patients who presented to Zhejiang Hospital between February 2024 and September 2025 and received active tetanus immunization for animal-related injuries, traffic accident injuries, sharp injuries, blunt injuries, and other injuries were enrolled ( n = 6,428). Patients’ baseline data, environmental characteristics, injury types, and other vaccination-related information were collected and analyzed. Univariable and multivariable logistic regression analyses were performed to identify risk factors for delayed or incomplete tetanus immunization among patients presenting to our hospital. Results A total of 6,428 patients attending the post-tetanus-exposure management outpatient clinic from February 2024 to September 2025 were enrolled. Delayed injection or incomplete vaccination was identified in 1,009 cases, yielding an overall abnormal vaccination rate of 15.7%. Population and exposure characteristic analysis showed that vaccination abnormalities were concentrated among staff/workers aged 45–64 years. Animal-related injury was the predominant cause of injury, with dog and cat injuries accounting for 50.1% and 39.9%, respectively, together representing 90.0% of all animal-induced injuries. Most injuries occurred outdoors, and wounds were predominantly single upper-limb injuries; the majority of exposures were classified as high risk. Individual risk association analysis revealed that age was the primary risk factor for vaccination abnormalities:each 1-year increase in age increased the odds of delayed injection/incomplete vaccination by 22.5%. Marked age-stratified patterns were observed, with an extremely low incidence among those aged≤35 years and a significantly increasing risk with age among those aged ≥36 years; occupational differences were also significant. Conclusion Patients with delayed or incomplete tetanus vaccination after exposure were predominantly staff/workers aged 45–64 years; animal-induced injury and outdoor injury were key independent risk factors for delayed/incomplete vaccination. Clinically, stratified management should be implemented, with strengthened health education and follow-up targeting older adult(s) patients, mobile populations injured outdoors, and patients with animal-induced injuries. Given the higher proportion of delayed/incomplete vaccination in cold months and the peak of exposure-related visits in warm months, follow-up strategies should be optimized to reduce the risk of delayed and incomplete vaccination and to improve the standardization of post-tetanus-exposure management.