Reactogenicity and immunogenicity of adult versus paediatric diphtheria and tetanus booster dose at 6 years of age

A Modified Vaccine Reduces the Rate of Large Injection Site Reactions to the Preschool Booster Dose of Diphtheria-Tetanus-Acellular Pertussis Vaccine

“…The vaccines were from a different manufacturer than the ones we studied. In each of the comparative studies 26,27,37 and in the present report, immune responses to the lower dosage booster vaccines were satisfactory but somewhat less than those to full dose vaccines. All children in the present study had antitoxin responses in excess of the conservative threshold for protection (Ն0.1 IU/mL) after the reduced dose of diphtheria toxoid in Tdap, which others 40 have projected to result in prolonged antibody seroprotection rates comparable with those after DTaP.…”

“…Recent European studies 26,37 demonstrated that tetanus with low dose diphtheria vaccine and Td.IPV vaccines caused fewer local reactions with midchildhood booster doses than vaccines with a full pediatric dosage of diphtheria toxoid. Currently the Netherlands, Luxembourg, Denmark and Germany recommend use of low dosage diphtheria-containing vaccines for boosters at 4 -6 years of age.…”

Sex differences in injection site reactions with human vaccines

“…94 In the study by Cook et al 59 with 23-valent pneumococcal vaccine, 33 patients reported significant local reactions, of these 27 had pre-existing antibody titres of the three serotypes tested of >1 μg/ml and of these 21 were females. Facktor et al 94 in a study of hypersensitivity reactions following booster dose of a fluid tetanus toxoid, observed that Arthus type reactions were observed in 24% females and 39% males and that greater incidence of this reaction in males than females coincided with the higher pre-booster mean tetanus antibody titres in males compared with females.…”

Booster Vaccination: The Role of Reduced Antigen Content Vaccines as a Preschool Booster

“…A study conducted in Italy by comparing the two formulations showed a statistically higher geometric title against diphtheria (anti-D) in subjects who had received DT than that observed in subjects treated with dT (14.1 IU/mL versus 7.7 IU/mL, P < 0.001). The authors consider that the higher antibody response and the comparable reactogenicity of the two products would suggest a preferential use of the DT product in preschool age, especially if no additional boosters in adolescence or adulthood are provided [18]. It is noteworthy that data in this paper show that the use of standard dose (DT) resulted in a significantly higher frequency of redness, swelling, and pain at the injection site, of any degree or severity.…”

“…Such considerations would favour the introduction of dTap-IPV in the preschool age [16], but the same has not yet been recommended at European and national level [3, 5, 17]. In particular, fears have been expressed on the lower antibody titer elicited against diphtheria by dTap-IPV compared to DTaP-IPV and on the related shorter immune protection that this would allow [5, 18]. Taking into account the relevance of safety/tolerability in the compliance with vaccination among the population, and, in the case of Italy, having to increase vaccine coverage up to 95%, as prescribed by PNPV 2012–2014, it has been considered appropriate to assess whether today enough scientific evidences are available to support the use of dTap-IPV booster in preschool age.…”