Immunogenicity and reactogenicity of the adult tetanus–diphtheria vaccine. How many doses are necessary?

Abstract

The immunogenicity and reactogenicity of the tetanus-diphtheria adult type vaccine was compared in two groups: group I (n = 201, 18-30 years old, presumably vaccinated with the DTP vaccine) and group II (n = 147, > or = 45 years old, without vaccination antecedents). Before vaccination, the seroprotection levels for tetanus were 90.5% (group I) and 30.6% (group II). These rose to 99.5% and 81.7%, respectively, after administration of one vaccine dose. For diphtheria, prevaccination seroprotection levels were 38.3% (group I) and 19.0% (group II). These rose to 85.8% and 65.7%, respectively, after vaccination. The logistic regression analysis showed an association between antibody titre and age. In group II, 3 doses of Td vaccine were needed to reach titres similar to those achieved in group I with a single dose. Stated reactogenicity was greater in: young subjects, women, those with higher titres of tetanus antibodies and those receiving other vaccines simultaneously. These results confirm the need for vaccination schedules adapted to the characteristics of each population age-group.

Adult vaccination against tetanus and diphtheria: the European perspective

“…In a longitudinal observation, the half‐life of tetanus antibodies has been estimated to be 11 years , and similar results have also been reported for diphtheria‐specific antibodies . Tetanus‐ and diphtheria‐specific antibody concentrations are frequently below the levels considered to be protective (> 0·1 IU/ml) for adults and particularly for elderly people, as shown in cohorts from Spain , Belgium and Australia , Italy and France (Table ). On average, the last vaccination dated back longer in people without protective antibodies, as shown for diphtheria (16·1 years versus 7·2 years) .…”

Incomplete Immune Reconstitution after Initiation of Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus–Infected Patients with Severe CD4+Cell Depletion

“…Ninety-four percent of patients developed protective levels of anti-TT antibody after booster immunization, whereas the response rate of demographically similar but not HIV-infected adults is virtually 100% [25][26][27][28]. Furthermore, the fold increase in anti-TT IgG antibodies was only 1.7 in our patient population, whereas it typically exceeds 10 among healthy control subjects.…”

Sex differences in injection site reactions with human vaccines

“…F > M Diphtheria/tetanus toxoid (Td) Prospective, non-randomized study: Local reaction, Bayas et al 30 Previously vaccinated: n = 201, F > M 61 M, 140 F; age range 18-30 yrs. Not previously vaccinated, n = 147, 65 M, 82 F; aged >45 yrs.…”