Fall‐off in immunity following diphtheria revaccination ‐ an 8 year follow‐up study

Abstract

Heron, I. Fall-off in immunity following diphtheria revaccinationan 8-year follow-up study. APMIS 104: 921-925, 1996. Diphtheria may occur even among previously vaccinated persons and knowledge of the duration of immunity is of crucial importance when designing effective vaccination programmes. In a follow-up study of 42 representative probands revaccinated 8 years previously, a continuous fall-off in antitoxic immunity was demonstrated. 98%) were still protected (antitoxin concentration >0.01 IU/ml). From the distribution of titres in the group the individual risk of susceptibility 8 years after revaccination was calculated to be 0.8% (0.2-2.9%, 95' %1 confidence limits). Thus, repeated revaccinations are required to secure continuous protection. The fall-off pattern for diphtheria antitoxin was approximately the same as for tetanus antitoxin. Peak values following revaccination are decisive for the duration of immunity. As peak values following vaccination depend on naturally acquired immunity and consequently decrease as indigenous diphtheria in a population disappears, highly potent vaccines are required to secure long-term immunity following diphtheria revaccination. The effects of dose and adjuvant are discussed.

Long Antibody Persistence and Transgenerational Transfer of Immunity in a Long-Lived Vertebrate

“…Secondary immune responses are known to be mounted faster and result in higher levels of specific antibodies compared with primary responses in poultry and short-lived passerine birds (Ardia et al 2003;Råberg and Stjernman 2003;Beal et al 2004;). However, little is known regarding their persistence in time, despite their importance for wild long-lived species (Simonsen et al 1996). Our study provides confirming evidence that secondary immune responses in long-lived species may result in neither longer nor stronger persistence of specific antibodies (Damme et al 2003;Leuridan et al 2010;Ott et al 2012).…”

Comparative seroepidemiology of diphtheria in six European countries and Israel

“…The highest incidence rates were among adolescents and adults aged 40–49 years [8]. As many cases occurred in adults most of whom would have been previously vaccinated, it seems that immunity as well as antibody levels may have declined following vaccination [9]. Although the reasons for the diphtheria epidemic in the NIS are not fully understood, factors contributing to the epidemic included a large population of susceptible adults, decreased childhood immunization coverage, suboptimal socioeconomic conditions and high population movements [8, 10].…”

Reduced Antibody Responses to Vaccinations in Children Exposed to Polychlorinated Biphenyls

“…Antibody formation to such antigens is dependent on antigen presentation, T lymphocyte function, and B lymphocyte function and therefore reflects overall efficacy of the immune system in relation to infection [ 8 ]. Because standardized methods for antibody assessment and extensive experience on vaccine efficacy are available, antibody responses to diphtheria toxoid and tetanus toxoid are highly suitable for this purpose [ 9 , 10 ].…”