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

Abstract

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...

Multilocus Sequence Typing Identifies Evidence for Recombination and Two Distinct Lineages of Corynebacterium diphtheriae

“…Edmunds et al estimated that there are inadequate protection levels in the United Kingdom for 70 to 75% of those aged 50 to 60 years old (7). Similar observations were recently reported for individuals who had followed the French vaccine recommendations (17).…”

Booster vaccination against tetanus and diphtheria: insufficient protection against diphtheria in young and elderly adults

“…Documentation of the primary vaccination is frequently poor for adults and particularly for the elderly as shown in several studies [7, 9]. It is therefore not clear, whether all participants had received a complete primary immunization.…”

Does vaccination ensure protection? Assessing diphtheria and tetanus antibody levels in a population of healthy children

“…No difference between the D and d dosages was found in France, either. [14] In the study by Tomovici et al, [15] 94.5% of teenagers tested before a booster injection had a protective diphtheria antibody titer, and 100% had a protective antibody titer against tetanus. After the booster injection, all patients developed a protective antibody titer, which persisted for the following 10 years.…”