Adult vaccination against tetanus and diphtheria: the European perspective

Abstract

SummaryBesides immunizations against influenza, Streptococcus pneumoniae and herpes zoster, which are recommended specifically for elderly people, regular booster vaccinations against tetanus, diphtheria and in some cases pertussis and polio are recommended in many European countries for adults, including elderly people. Vaccination recommendations for adults differ greatly between individual countries and coverage data is scarce. Tetanus-specific antibody concentrations are generally higher than diphtheria-specific antibodies, and a substantial proportion of adults, and particularly of elderly people, do not have protective antibody concentrations against diphtheria. Antibody levels increase upon booster vaccination in all age groups, but diphtheria-specific antibody concentrations remain below protective levels in some older individuals, even immediately after vaccination and long-term protection is frequently not achieved. Future vaccination strategies should therefore include regular and well-documented booster shots, e.g. against tetanus and diphtheria, throughout life.

Life-course immunization as a gateway to health

“…Furthermore, due to the success of childhood vaccination programs, the burden of some infectious diseases has greatly decreased in children, shifting the bulk of the disease burden to older age groups. As a result, in regions such as Europe with good vaccine coverage in children, tetanus and diphtheria are now primarily seen in unvaccinated older adults [11].…”

“…Tetanus and diphtheria are other examples. The WHO recommends a primary vaccination series against tetanus and diphtheria during childhood and regular booster vaccinations throughout life [43,45] and many countries recommend these vaccines throughout adulthood, sometimes in combination with pertussis vaccine [11,28]. However, coverage rates remain below 75% [23].…”

Relationship Between Tetanus Antitoxin Titration Level and Vaccination History

“…In another study conducted in Italy in 2003-2004, a lack of protective tetanus antitoxin levels were found among 56.6% of participants aged 45-64, 73.4% in the age group 65-75, 72.1% in the age group 76-84 and 82.9% among participants over 85 years of age, indicating a gradual decline in tetanus antitoxin levels within years [16]. The fact that 80.2% of the cases of tetanus occurring between 2001 and 2010 in Italy were reported in the population aged 65 years and over and 36 (62%) of the 58 cases of tetanus reported between 1993 and 2007 in Australia were also over 65 years of age supports this increasing risk with increasing lag of time from last the booster dose [17][18]. Our finding of antitoxin levels decreasing 0.9-fold annually independent of gender also supports this increasing risk with age.…”

Pathogenesis of Corynebacterium diphtheriae and available vaccines: An Overview

“…Currently, in the United States, the pediatric formulation It has been reported in several studies that protective antibody levels of tetanus and diphtheria wilted since the last vaccination because of aging, and antibodies had on estimated the half-life of 11 years [6,27]. These data better explain the reason behind the lack of antibody in the older age.…”

“…Public infectious diseases have positively been controlled by vaccination, yet, the importance of vaccination usually remained unnoticed for the adults [6]. Many of the under development vaccines are directed towards the childhood immunization [7].…”