一位 60 歲病人詢問為何小時候打過疫苗，現在仍需要追加破傷風疫苗。護理師應如何回答？
A 60-year-old client asks why they need a tetanus booster since they were vaccinated as a child. How should the nurse respond?
- AThe booster is required by insurance companies保險公司規定必須施打加強劑
- BImmunity against tetanus decreases over time✓ 正解對破傷風的免疫力會隨時間減退
- CThe vaccine formulation has changed significantly疫苗配方已大幅改變
- DAdults have a higher risk of contracting tetanus成人感染破傷風的風險較高
破傷風（Tetanus）是由破傷風桿菌引起的疾病，其疫苗產生的抗體效價會隨時間自然衰減。並非終身免疫，因此成人需要定期追加接種以維持保護力。臨床上，若病人發生污染性傷口（如穿刺傷、燒傷、動物咬傷），確認疫苗接種史至關重要。建議成人每 10 年接種一次 Td（破傷風與減量白喉混合疫苗）或 Tdap（含百日咳成分）。
Tetanus is caused by Clostridium tetani, and the antibody titer produced by the vaccine naturally declines over time. Immunity is not lifelong, and adults therefore need periodic booster doses to maintain protection. Clinically, when a patient has a contaminated wound (such as a puncture wound, burn, or animal bite), confirming vaccination history is essential. The recommendation is for adults to receive Td (tetanus and reduced-dose diphtheria toxoid) or Tdap (which includes a pertussis component) every 10 years.
美國非常強調成人 Tdap 接種（特別是接觸嬰兒者以預防百日咳），而台灣臨床針對成年人破傷風追加接種的執行強度與衛教普及度，較美國略低。