Serologic Immunity to Diphtheria and Tetanus in the United States

McQuillan, Geraldine M.; Kruszon-Moran, Deanna; Deforest, Adamadia; Chu, Susan Y.; Wharton, Melinda

doi:10.7326/0003-4819-136-9-200205070-00008

Cited by 185 publications

(116 citation statements)

References 13 publications

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“…However, adolescents older than 15 years had higher antibody levels than those younger than 15 for tetanus (0.972 vs 0.390, respec- munity, more individuals with up-to-date vaccination cards were found to be fully protected against tetanus. These findings confirm that, as age progresses, a person's susceptibility to tetanus and diphtheria increases if booster doses are omitted (8,9,14,(16)(17)(18)(19).…”

supporting

confidence: 74%

Tetanus and diphtheria immunity in adolescents from São Paulo, Brazil

Dinelli¹,

Fisberg²,

Moraes-Pinto³

2007

Braz J Med Biol Res

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Tetanus and diphtheria vaccines are of special concern in adolescents because boosters are necessary for adequate maintenance of protection and are often omitted. We assessed serum levels of tetanus and diphtheria antibodies in adolescents and their association with vaccination status. From May to October 2001, we evaluated the vaccination records of 208 adolescents aged 10 to 20 years in São Paulo, Brazil. Antibodies to tetanus and diphtheria were detected using double-antigen ELISA and vaccination records were analyzed according to the guidelines of the Brazilian National Immunization Program. All adolescents had received complete primary vaccinations against tetanus and diphtheria, but 23.1% of them had not received a booster dose in the last 10 years. All adolescents were immune to tetanus and 88.9% were fully protected (antibodies ≥0.1 IU/mL). One individual (0.5%) was non-immune to diphtheria and 86% were fully protected against the disease. Adolescents with up-to-date vaccination records had higher antibody levels than those with not up-to-date records for tetanus (0.763 vs 0.239 IU/mL, t-test: P < 0.0001) and diphtheria (0.366 vs 0.233 IU/mL, t-test: P = 0.014). Full immunity against tetanus (antibodies ≥0.1 IU/mL) was higher among individuals with up-to-date vaccination (93.1%) when compared to those with not upto-date records (75%, Fisher's exact test: P = 0.001). All adolescents had received basic immunization in childhood and were protected against tetanus and diphtheria. However, these data indicate that more emphasis should be placed on the tetanus-diphtheria booster in order to avoid a decay in antibody levels.

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supporting

confidence: 74%

Tetanus and diphtheria immunity in adolescents from São Paulo, Brazil

Dinelli¹,

Fisberg²,

Moraes-Pinto³

2007

Braz J Med Biol Res

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“…They also correlate with data from different studies showing that many American and European subjects over 50 years old do not have sera protective concentrations of anti-DT antibodies. [14][15][16] Despite the fact that a second booster was not recommended in France before 1998, we observed that 74% of the subjects had received more than one pertussis booster. Anti-PT antibody of ≥125 IU/mL suggesting a very recent infection were found in 7.6% of the study population, and this percentage was higher (13.4%) in those aged 18-29 years (mean age, 23 years; 95% CI, 21.27-24.75).…”

Section: Resultsmentioning

confidence: 85%

Antibodies to tetanus, diphtheria and pertussis among healthy adults vaccinated according to the French vaccination recommendations

Launay¹,

Toneatti²,

Bernède³

et al. 2009

Human Vaccines

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was replaced in 2005 by a pertussis subunit vaccine. This acellular pertussis vaccine for children, which had been used since 1998 for adolescents only, contains either two or three bacterial proteins. The acellular pertussis vaccine for adults contains either three or five bacterial proteins in reduced doses compared with those used for children. Since 1966, childhood vaccination against these four diseases has been via a combined diphtheria-tetanus-wholecell-pertussis-inactivated-poliomyelitis vaccine, to which a vaccine against Haemophilus influenza b was added in 1992.The French vaccine calendar originally consisted of a primary vaccination against diphtheria, tetanus, polio and pertussis at age 3, 4 and 5 months and one booster at age 16-18 months. Since 1995, the primary vaccination has been administered at age 2, 3 and 4 months. 1 Boosters comprising a combined diphtheria-tetanus-inactivated-polio vaccine were administered at age 5-7 years, 11-13 years and 16-18 years, followed by a combined tetanus-inactivated-polio vaccine every 10 years thereafter. In 1998, recommendations stated that a combined vaccine including acellular pertussis vaccine and the three other vaccines should be administered at age 11-13 years and these recommendations were extended in 2004 to young adults of reproductive age and health-care workers in contact with newborn babies. A booster with a reduced dose of diphtheria toxoid was added for adult travellers in 1994. In 2005, adults were advised to receive a diphtheria-vaccine booster every 10 years.Since 1966, vaccination coverage has always been very high for primary vaccination (>93%) and the first booster (85-92%) in France. 2,3 In contrast, vaccination coverage is lower in people aged more than 16 years: 88.5% for tetanus vaccine, 66% for poliomyelitis and 57.1% for diphtheria in a study performed in 2002. 3 In subjects aged more than 65 years, boosters for tetanus, poliomyelitis and diphtheria had been received by only 60.5%, 19.3% and 10.5%, respectively, of the study population. 3 Vaccination against tetanus has resulted in the disappearance of this disease in children and adolescents in France. However, 67 cases of tetanus were reported between 2002 and 2004: 64 cases occurredIn this sero-epidemiological study, we investigated humoral immunity to three vaccine-preventable diseases-tetanus, diphtheria and pertussis-among 331 adults (aged 18-60 years) attending vaccination centres for travellers and who had been vaccinated according to national recommendations in France. Serological results showed that the percentage of subjects with antibodies to diphtheria and tetanus decreases with age. Results also confirmed surveillance data on vaccination in France, with 7.6% of the study population (13.4% of those aged 18-29 years) having recently acquired a pertussis infection. These results confirm the importance of following French recommendations for regular boosters for tetanus and diphtheria among adults. They also indicate the need for better implementation of the current recomm...

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“…Serologic and survey data indicate that US adults are undervaccinated with Td, and that rates of coverage decline with increasing age. 11,12 In addition, studies of adult vaccination practices have found specialty-based differences in influenza and pneumococcal immunization practices; 13,14 similar differences may exist for Td, and potentially for Tdap vaccine as well.…”

Section: Introductionmentioning

confidence: 99%

New Combined Tetanus-Diptheria-Acellular Pertussis Vaccines for Adults: Primary Care Physician Attitudes and Preferences

Davis

Kretsinger²,

Cowan

et al. 2007

Human Vaccines

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Availability of combined tetanus-diphtheria-acellular pertussis (Tdap) vaccines for adults offers a new pertussis prevention strategy for the US. Successful uptake of Tdap vaccine will depend partly on the attitudes and practices of primary care physicians, including their experience with Td boosters. We conducted a mail survey in August 2005 of a national random sample of 399 family physicians (FPs) and 399 general internists (IMs) to assess practices related to Td boosters, clinical experience with pertussis, and attitudes toward a potential Tdap vaccine recommendation for adults. The response rate was 49% (52% FPs, 46% IMs). Among 336 eligible respondents, half reported having clinical experience with pertussis. Most (81%) would recommend Tdap vaccine for their adult patients, and 73% support targeting adults likely to come in close contact with infants. Attitudes toward a potential Tdap vaccine recommendation differed by whether providers stock and administer Td boosters. We conclude that adult primary care providers in the US are likely to recommend Tdap vaccine to their adult patients, in concordance with recent national recommendations. Future research should assess the extent to which barriers impede adoption of Tdap vaccine recommendations.

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Serologic Immunity to Diphtheria and Tetanus in the United States

Cited by 185 publications

References 13 publications

Tetanus and diphtheria immunity in adolescents from São Paulo, Brazil

Tetanus and diphtheria immunity in adolescents from São Paulo, Brazil

Antibodies to tetanus, diphtheria and pertussis among healthy adults vaccinated according to the French vaccination recommendations

New Combined Tetanus-Diptheria-Acellular Pertussis Vaccines for Adults: Primary Care Physician Attitudes and Preferences

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