Levels of diphtheria and tetanus specific IgG of Portuguese adult women, before and after vaccination with adult type Td. Duration of immunity following vaccinationReportar como inadecuado




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BMC Public Health

, 7:109

First Online: 12 June 2007Received: 08 October 2006Accepted: 12 June 2007DOI: 10.1186-1471-2458-7-109

Cite this article as: Gonçalves, G., Santos, M.A., Frade, J.G. et al. BMC Public Health 2007 7: 109. doi:10.1186-1471-2458-7-109

Abstract

BackgroundThe need for tetanus toxoid decennial booster doses has been questioned by some experts. Several counter arguments have been presented, supporting the maintenance of decennial adult booster doses with tetanus and diphtheria toxoids adult formulation of the vaccine: Td. This study aimed to evaluate the use of Td in Portuguese adult women under routine conditions. For that purpose we selected a group of women 30+ years of age to which vaccination was recommended. We intended to know if pre-vaccination antibody concentrations were associated with factors as age at first and last vaccination, number of doses and time since last revaccination. We also intended to assess the serological efficacy of Td booster.

MethodsFollowing the Portuguese guidelines 100 women were vaccinated with Td. Antitetanus toxin IgG ATT IgG and antidiphtheria toxin IgG ADT IgG levels were measured mIU-ml in 100 pre-vaccination and 91 post-vaccination sera. Detailed vaccination records were available from 88 participants.

ResultsTwenty-two women Group A began vaccination with DPT-DT in their early childhood and their pre-vaccination ATT IgG levels increased with the number of doses received p = 0.022 and decreased with time since last vaccination p = 0.016. Among the 66 women who began vaccination in adolescence and adulthood Group B, with monovalent TT, ATT IgG levels decreased with age at first dose p < 0.001 and with time since last vaccination p = 0.041. In Group A, antidiphtheria toxin IgG kinetics was very similar to that observed for ATT IgG. Among women not vaccinated with diphtheria toxoid, ADT IgG levels decreased with age. Serological response to both components of Td was good but more pronounced for ATT IgG.

ConclusionOur study suggests that, to protect against tetanus, there is no need to administer decennial boosters to the Portuguese adults who have complied with the childhood-adolescent schedule 6 doses of tetanus toxoid. The adult booster intervals could be wider, probably of 20 years. This also seems to apply to protection against diphtheria, but issues on the herd immunity and on the circulation of toxigenic strains need to be better understood.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-7-109 contains supplementary material, which is available to authorized users.

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Autor: Guilherme Gonçalves - Maria Augusta Santos - João Graça Frade - José Saraiva Cunha

Fuente: https://link.springer.com/







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