Front Cell Infect Microbiol. 2026 Mar 13;16:1766140. doi: 10.3389/fcimb.2026.1766140. eCollection 2026.
ABSTRACT
BACKGROUND: Tetanus is a severe but vaccine-preventable disease controlled by tetanus toxoid (TT) immunization and tetanus immunoglobulin (TIG) therapy. Although maternal-neonatal tetanus has been eliminated in many regions, coverage gaps and sporadic cases persist in low-resource settings. As a longstanding component of global immunization and a key conjugate carrier platform, tetanus research remains essential despite advances in novel vaccine technologies. However, the global research landscape on tetanus vaccines and immunoglobulins remains unmapped.
OBJECTIVE: This study aimed to conduct a comprehensive bibliometric analysis of publications on TT and TIG from 2000 to 2025, to characterize research dynamics, leading contributors, and thematic evolution.
METHODS: We retrieved publications from the Web of Science Core Collection (SCI-Expanded) for 2000-2025 using relevant keywords (“tetanus vaccine*” OR “tetanus toxoid*” OR “tetanus immunoglobulin*” OR “tetanus immune globulin*” OR “tetanus antitoxin*”). Following screening, 2,949 English-language articles and reviews were included. Bibliometric analyses (publication trends, funding agencies, co-authorship, co-citation, and keyword co-occurrence) were performed using VOSviewer, CiteSpace, and the bibliometrix R package.
RESULTS: A total of 2,949 publications were analyzed. Annual output remained stable (mean ≈ 113.4), with citations peaking in 2021 (n=7,291). The USA led in volume (1,130 papers), while Switzerland achieved the highest impact (88.41 citations/article). The Centers for Disease Control and Prevention (CDC) and University of Oxford emerged as central hubs, with GlaxoSmithKline (GSK) illustrating the role of industry-academic partnerships. A strategic funding shift occurred around 2010: while the National Institutes of Health (NIH) drives foundational research, the Bill & Melinda Gates Foundation (BMGF) has become the engine for translational equity. Evolutionary trends show a shift from early cellular mechanisms toward maternal immunization coverage, implementation determinants in low- and middle-income countries (LMICs), and the expanding utility of tetanus toxoid (TT) as a conjugate vaccine carrier.
CONCLUSION: Tetanus research has evolved into a dynamic model for modern vaccinology, bridging classical immunization and next-generation technology. Beyond maternal protection, the field is expanding toward conjugate platforms and recombinant biologics. Achieving global elimination requires aligning these biotechnological innovations with equitable implementation strategies in low-resource settings.
PMID:41909843 | PMC:PMC13021605 | DOI:10.3389/fcimb.2026.1766140
