Lack of early antitoxin response to tetanus booster

“…Likewise, modelization of antibody titers clearly showed similar profiles in the two groups until the seventh day. Our results demonstrate the absence of an early antitoxin response to the tetanus booster, similar to previous observations (23,28,33). We estimate that the formation of antibodies in response to vaccination occurs at about day 6.…”

Section: Discussionsupporting

confidence: 93%

Evaluation of the Safety and Pharmacokinetic Profile of a New, Pasteurized, Human Tetanus Immunoglobulin Administered as Sham, Postexposure Prophylaxis of Tetanus

Forrat

Dumas

Seiberling³

et al. 1998

Antimicrob Agents Chemother

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In a monocentric, double-blind, randomized trial, we examined the safety and pharmacokinetic profile of a new, pasteurized, human tetanus immunoglobulin (P-HTIG). As part of the purification process, P-HTIG has undergone a heat treatment step (10 h at 60°C) and the removal of Merthiolate. Forty-eight adults with a history of tetanus vaccination were randomized into four groups (n = 12 per group) to receive one of two different batches of this P-HTIG simultaneously with either tetanus-diphtheria (Td) vaccine (sham, postexposure prophylaxis of tetanus) or placebo. Local reactions at the injection site were followed for the first 3 days after injection, and systemic reactions were followed during the entire study period, i.e., up to 42 days posttreatment. Blood samples for tetanus antibody titer determination (enzyme-linked immunosorbent assay method) were drawn prior to treatment on day 0 and on days 1, 2, 3, 7, 14, 21, 28, 35, and 42. A normalization of tetanus antibody titers (subtraction of the day 0 value for each subject at each time period) was performed to assess the additive effect of P-HTIG on tetanus antibody titers. The pharmacokinetic parameters were determined by both a compartmental analysis (modelization) and a noncompartmental analysis. No severe adverse reactions were reported. The rate of local reactions at the P-HTIG injection site was 27%. All local reactions were mild and resolved within 2 days. In contrast, local reactions at the vaccine injection site were seen in 79% of the subjects. The rate of systemic reactions was similar in the P-HTIG plus Td vaccine group (33%) and in the P-HTIG plus placebo group (21%), and all these reactions were mild. In the P-HTIG plus placebo group, tetanus antibody titers rose to a maximum of 0.313 ± 2.49 IU/ml after 4.4 days; in the P-HTIG plus Td vaccine group, a maximum concentration of 15.2 ± 2.42 IU/ml was reached 19 days postinjection. In both groups, 100% of the patients had seroprotective levels of tetanus antibodies (≥0.01 IU/ml) 2 days following treatment. An anamnestic response to Td vaccine appeared 7 days postimmunization. In conclusion, P-HTIG has a good safety and pharmacokinetic profile. Our results confirm that immunoglobulin should be associated with vaccine in the treatment of tetanus-prone wounds.

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“…This is of clinical importance in view of the absence of an early antitoxin response to tetanus booster in our study, similar to previous observations, when a delay in the response to the vaccine may occur, such as among the elderly or those not previously-immunized. 13,[19][20][21] The relatively moderate and similar tetanus antibody response to one dose of Td vaccine in the two groups contrasts sharply with the brisk anamnestic response observed after one dose of Td vaccine in European subjects, all of whom had been immunized by potent tetanus toxoid at least 10 years before. 13 According to the inclusion criteria, the enrolled subjects in the current study had not received tetanus vaccination for at least ten years, and probably most of them had incomplete primary immunization.…”

Section: Discussionmentioning

confidence: 99%

Safety and immunogenicity of a new equine tetanus immunoglobulin associated with tetanus-diphtheria vaccine.

Lang¹,

Kamga-Fotso²,

Peyrieux³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

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Abstract. In a single-center double-blind, randomized trial in West Africa, we evaluated the safety and immunogenicity of a new pasteurized, pepsin-digested equine tetanus immunoglobulin (heat-treated equine tetanus immunoglobulin [HT-ETIG]) in the post-exposure prophylaxis of tetanus compared with the reference product, equine tetanus immunoglobulin (ETIG). A total of 134 adults presenting to Garoua Hospital, Cameroon with a tetanus-prone wound were randomized to receive a 3,000 international units (IU) intramuscular injection (deltoid) of either HT-ETIG or ETIG, simultaneously with a tetanus-diphtheria vaccine. No serious adverse reactions were reported. The incidences of local and systemic reactions were similar in the two groups. Repeated measures of equine tetanusantibody levels measured from Day 0 to Day 28 showed that titers were significantly higher in the HT-ETIG group (P ϭ 0.017). At Day 7, a higher percentage of subjects in the HT-ETIG group had equine antibody levels Ն 0.1 IU/ ml (80.4% versus 37.9%; P Ͻ 0.0001). No cases of tetanus occurred during the follow-up, attesting to the efficacy of the combined prophylactic treatment.

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Lack of early antitoxin response to tetanus booster

Cited by 7 publications

References 11 publications

Combined diphtheria???tetanus???pertussis vaccine for tetanus-prone wound management in adults

Combined diphtheria???tetanus???pertussis vaccine for tetanus-prone wound management in adults

Evaluation of the Safety and Pharmacokinetic Profile of a New, Pasteurized, Human Tetanus Immunoglobulin Administered as Sham, Postexposure Prophylaxis of Tetanus

Safety and immunogenicity of a new equine tetanus immunoglobulin associated with tetanus-diphtheria vaccine.

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