Evaluation of vaccination requirements to secure continuous antitoxin immunity to tetanus

Simonsen, Ole; Bentzon, Michael Weis; Kjeldsen, Keld; Venborg, Hans-Aage; Heron, Iver

doi:10.1016/0264-410x(87)90057-0

Cited by 39 publications

(13 citation statements)

References 15 publications

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“…remains to develop novel immunogens that can extend these results, the parallel development of adjuvants that enhance the magnitude and durability of desirable responses is critically important. zation (45,46). Although we do not have data extending over multiple years, our demonstration of sustained antibody levels lasting for 1 year (Fig.…”

Section: Discussionmentioning

confidence: 76%

Toll-Like Receptor 7/8 (TLR7/8) and TLR9 Agonists Cooperate To Enhance HIV-1 Envelope Antibody Responses in Rhesus Macaques

Moody

Santra

Vandergrift

et al. 2014

J Virol

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The development of a vaccine that can induce high titers of functional antibodies against HIV-1 remains a high priority. We have developed an adjuvant based on an oil-in-water emulsion that incorporates Toll-like receptor (TLR) ligands to test whether triggering multiple pathogen-associated molecular pattern receptors could enhance immunogenicity. Compared to single TLR agonists or other pairwise combinations, TLR7/8 and TLR9 agonists combined were able to elicit the highest titers of binding, neutralizing, and antibody-dependent cellular cytotoxicity-mediating antibodies against the protein immunogen, transmitted/ founder HIV-1 envelope gp140 (B.63521). We further found that the combination of TLR7/8 and TLR9 agonists was associated with the release of CXCL10 (IP-10), suggesting that this adjuvant formulation may have optimally stimulated innate and adaptive immunity to elicit high titers of antibodies. IMPORTANCECombining TLR agonists in an adjuvant formulation resulted in higher antibody levels compared to an adjuvant without TLR agonists. Adjuvants that combine TLR agonists may be useful for enhancing antibody responses to HIV-1 vaccines.

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Section: Discussionmentioning

confidence: 76%

Toll-Like Receptor 7/8 (TLR7/8) and TLR9 Agonists Cooperate To Enhance HIV-1 Envelope Antibody Responses in Rhesus Macaques

Moody

Santra

Vandergrift

et al. 2014

J Virol

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“…Individuals who have received a complete five-dose vaccination course should have immunity to tetanus that persists for about 20 years 13. After this time, additional booster doses are given to travellers going to regions where medical attention is not available 1.…”

Section: Tetanus Vaccinationmentioning

confidence: 99%

“…However, some data indicate that restricting immunisation to five tetanus toxoid doses may compromise immune status: Simonsen et al 13 showed that serum tetanus antitoxin titres gradually subside after immunisation. As a result, 28% of individuals, who had undergone full primary vaccination, had low antitoxin titres 25–30 years later 15.…”

Section: Tetanus Vaccination Guidelinesmentioning

confidence: 99%

Are current UK tetanus prophylaxis procedures for wound management optimal?

Cooke

2009

Emergency Medicine Journal

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Tetanus is a potentially fatal disease that occurs after contamination of a wound with Clostridium tetani spores. The introduction of comprehensive infant vaccination programmes in the 1960s dramatically reduced the incidence of tetanus in the UK. To achieve comprehensive protection against tetanus, the World Health Organization guidelines recommend the administration of the five-dose childhood immunisation regimen and an additional sixth dose, after approximately 10 years, to ensure long-lasting immunity. To supplement these measures, tetanus prophylaxis with human tetanus immunoglobulin is considered essential for incompletely immunised individuals presenting with dirty wounds. However, identifying those individuals who are not fully immunised has, until recently, been problematical. The use of a new rapid, point-of-care immunoassay to assess tetanus immune status may facilitate the optimal management of patients with wounds.

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“…22,74 The length of long-term protection after five or six doses is uncertain, but seems to be at least 20-25 years in populations receiving primary doses in infancy, and boosters in childhood and adolescence. [86][87][88] Recommended vaccination schedules vary by country. WHO recommends that at least five doses of tetanus toxoid vaccine be given over 12-15 years, starting in infancy; a sixth dose given in early adulthood is encouraged, to ensure longlasting protection.…”

mentioning

confidence: 99%

Maternal and Neonatal Tetanus

Roper

Vandelaer

Gasse

2008

Obstetric Anesthesia Digest

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Maternal and neonatal tetanus are important causes of maternal and neonatal mortality, claiming about 180 000 lives worldwide every year, almost exclusively in developing countries. Although easily prevented by maternal immunisation with tetanus toxoid vaccine, and aseptic obstetric and postnatal umbilical-cord care practices, maternal and neonatal tetanus persist as public-health problems in 48 countries, mainly in Asia and Africa. Survival of tetanus patients has improved substantially for those treated in hospitals with modern intensive-care facilities; however, such facilities are often unavailable where the tetanus burden is highest. The Maternal and Neonatal Tetanus Elimination Initiative assists countries in which maternal and neonatal tetanus has not been eliminated to provide immunisation with tetanus toxoid to women of childbearing age. The ultimate goal of this initiative is the worldwide elimination of maternal and neonatal tetanus. Since tetanus spores cannot be removed from the environment, sustaining elimination will require improvements to presently inadequate immunisation and health-service infrastructures, and universal access to those services. The renewed worldwide commitment to the reduction of maternal and child mortality, if translated into effective action, could help to provide the systemic changes needed for long-term elimination of maternal and neonatal tetanus.Tetanus in the first 28 days of life (neonatal tetanus) was long recognised by clinicians in resource-poor settings as an important cause of neonatal death. However, since babies affected by this disease usually are born at home and die there without registration of either event, the true burden was unknown. In the 1970s and 1980s, community-based surveys about neonatal tetanus from more than 40 countries showed that fewer than 10% of tetanus-related cases and deaths were routinely reported in most countries: in some regions, the reporting fraction was as low as 2-5%. 1,2 Estimates based on the results of these surveys, and tetanus data routinely reported to WHO suggested that, in the 1980s, more than 1 million deaths every year were attributable to tetanus, with an estimated 787 000 deaths in 1988 from neonatal tetanus alone. 1,3 In 1989, the worldwide public-health community made a commitment to the elimination of neonatal tetanus (defined as fewer than one case of neonatal tetanus per 1000 livebirths in all districts) by 1995. 3,4 Maternal tetanus is defined as tetanus during pregnancy, or within 6 weeks of the end of pregnancy (whether pregnancy ended with birth, miscarriage, or abortion), and has the same risk factors and means of prevention as neonatal tetanus. In the early 1990s it was estimated to account for about 5% of maternal mortality, or 15 000-30 000 deaths every year. 5,6 In 1999, the elimination of maternal tetanus was added to the goals of the elimination programme for neonatal tetanus, and the initiative was renamed the Maternal and Neonatal Tetanus Elimination Program. 6 Good progress has been made in the 15 ...

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Evaluation of vaccination requirements to secure continuous antitoxin immunity to tetanus

Cited by 39 publications

References 15 publications

Toll-Like Receptor 7/8 (TLR7/8) and TLR9 Agonists Cooperate To Enhance HIV-1 Envelope Antibody Responses in Rhesus Macaques

Toll-Like Receptor 7/8 (TLR7/8) and TLR9 Agonists Cooperate To Enhance HIV-1 Envelope Antibody Responses in Rhesus Macaques

Are current UK tetanus prophylaxis procedures for wound management optimal?

Maternal and Neonatal Tetanus

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