Booster Dose Of Tetanus Vaccine Research Articles

Do patients with diabetic foot ulcer need booster dose of tetanus vaccine?

Diabetic foot ulcer is a public health concern around the world. These wounds are prone to a variety of infections including Clostridium Tetani that may lead to tetanus. The aim of this study was to evaluate the immunity status as a result of tetanus vaccination and other preventive measures in these patients. We conducted a narrative review of previous studies which were related to the risk of tetanus infection in diabetic foot patients by searching electronic databases. It was found that usually tetanus antibody titers in diabetic patients are below the protective level and they are not appropriately vaccinated. Therefore, diabetes and lack of immunity, put diabetic foot ulcer patients more at risk of tetanus. But this problem is not given serious attention in diabetes care. Thus, it is recommended to provide specific guidelines for tetanus vaccination and prophylaxis in diabetic patients. These recommendations can play a vital role in the prevention of diabetic foot ulcers complication.

Seroepidemiology of tetanus in Hangzhou from 2009 to 2018

ABSTRACT Objective: The seroepidemiologic study aimed to delineate the immune status against tetanus in Hangzhou and its influential factors to provide evidence on strategies for tetanus prevention. Methods: We used a multi-stage stratified random sampling method to recruit participants from several Community Health Centers in Hangzhou during 2009–2018. Demographic data and vaccination histories of all subjects born during the period from 2004 to 2018 were collected from Hangzhou Immunization Information System (HZIIS), while the data of all subjects born before 2003 were acquired through case investigation. We used Enzyme Linked Immunosorbent Assay (ELISA) to detect Immunoglobulin G (IgG) antibodies against tetanus in serum samples and univariate and multivariate analysis to detect association between level of tetanus IgG and related factors. Results: A total of 3695 subjects were included, of which were 1904 males and 1791 females. About 59.84% of people had a clear immunization history of tetanus-toxoid-containing vaccines (TTCVs). The percentage of people whose tetanus IgG antibody titers were above the minimum protective level (0.1 IU/ml) was 76.02% (95% CI: 74.6–77.4%) and the geometric mean concentration (GMC) for tetanus IgG was 1.70 IU/ml. Antibody levels of people were higher in rural areas than in urban areas, in males than in females, in subjects who had inoculation vaccine history than those without inoculation of vaccine or with unknown history, and lower in groups aged >15 y compared to <15 y. Conclusions: The positive rate and GMC of tetanus IgG were significantly influenced by gender, age and immunization history of TTCVs. We should seek to achieve early and timely infant vaccination and maintain high coverage of the complete 3-dose primary series plus 3-dose booster series prior to adolescence. Besides basic immunization, we should stress the importance of using booster doses of tetanus vaccine in adolescents and adults; it is necessary to adopt corresponding immunization measures for women at childbearing age.

Tetanus in School Age Children Seen at the University of Port Harcourt Teaching Hospital: A Need for Booster Doses of Tetanus Vaccine

Background: Tetanus still causes significant morbidity and mortality amongst children in Nigeria despite decades of immunisation with tetanus vaccine.&#x0D; Objectives: To determine the prevalence, case fatality rate and predictors of fatality amongst school age children treated for tetanus at the University of Port Harcourt Teaching Hospital.&#x0D; Materials and Methods: This was a retrospective study of all children aged 4 to 17 years treated for tetanus at the University of Port Harcourt Teaching Hospital between January 1, 2009 and December 31, 2019. Data was obtained from the case notes and ward registers. Socio-demographic characteristics, presenting complaints, incubation period, onset interval, number of Diphtheria, Pertussis and Tetanus (DPT) vaccine received at infancy, treatment outcome, duration and cost of hospital stay were obtained, entered into a spread sheet and analysed with SPSS version 20. Results are presented in tables and percentages. The level of significance was set at P value &lt;0.05.&#x0D; Results: During the period under review, there were 53 children aged 4 to 17 years treated for tetanus, accounting for 0.3% of the total admission. The mean age was 10.79±3.35 years. There were 33 (62.26%) males and 20 (37.74%) females. Majority 26 (49.06%) of the children were of low socioeconomic class. The commonest 28(52.8%) route of infection was broomstick injury. Majority 32(60.3%) of the children were not immunised in infancy. The mean incubation period was 7.34±4.21 days and the mean onset interval was 8.87±10.44 hours. The two most common symptoms were generalized spasms 49 (21.03%) and trismus 47 (20.17%). Short incubation period (≤4 days) and short onset interval (≤4 hours) were significantly associated with higher death rates (p=0.0002; p=0.012). Patients with short incubation period of ≤4 days and short onset interval of≤ 4 hours are more likely to die (p=0.0002; p=0.012).&#x0D; Conclusion: There was a high tetanus case fatality rate amongst school age children at University of Port Harcourt. Short incubation period and onset interval were associated with higher mortality. Booster doses of TT containing vaccines should be administered to primary and secondary school children in Port Harcourt to curb the menace.

Is there any difference in tetanus IgG levels of diabetic patientswith respect to the presence of foot ulcers?

The aim of this study was to reveal the tetanus immunization status of diabetic patients and to determine whether diabetic patients with foot ulcers have different TIG levels. A cross-sectional study was designed that included diabetic patients with foot ulcers (n = 30) and diabetic patients without ulcers (n = 30). The groups were compared for serum TIG levels along with total serum protein, albumin, C-reactive protein (CRP), and total immunoglobulin G (Ig G). For diabetic patients without foot ulcers, 17 of 30 (56.6%) patients were found to have nonprotective TIG levels whereas for diabetic patients with foot ulcers, 28 of 30 (93.3%) patients were found to have nonprotective TIG levels. The mean value of TIG for diabetic patients without foot ulcers was 0.345 ± 0.281 IU/mL and for diabetic patients with foot ulcers the mean TIG value was 0.055 ± 0.033 IU/mL. Statistically significant differences were observed in TIG (P = 0.008), total protein (P < 0.001), albumin (P < 0.001), and CRP levels (P < 0.001) between the two groups. The majority of the diabetic patients had low TIG levels and they were significantly lower in diabetic patients with ulcers. A booster dose of tetanus vaccine should be considered for diabetic patients with and without diabetic foot ulcers.

Étude de l’immunité antitétanique chez les femmes enceintes durant l’année 2007 au service de maternité Souissi de Rabat

Summary The prevention against tetanus has considerably improved in the world. The eradication of neonatal tetanus is the one of the main aim of the WHO program. Even though the administration of tetanus toxoid has resulted in a decrease of the cases of tetanus in major industrialized countries, the situation in many developing countries is still alarming. In order to assess the impact of antitetanus vaccination, a prospective study was conducted from January 2007 to April 2007 in the emergency department of motherhood of Souissi for the assessment of the immune status of term parturient. We used immunochromatographic test for the detection of antitetanic antibodies. The results showed that 62% of cases (99 women) were immunized for tetanus, and 38% of the cases (61 women) were not. The strengthening of the immune status by the administration of booster doses of tetanus vaccine to teenagers and women of childbearing potential will enable the eradication of tetanus.

Serum antibodies to diphtheria-tetanus-pertussis vaccine components in Argentine children.

The Argentine vaccination schedule against diphtheria, tetanus and pertussis (DTP) recommends three doses of DTP vaccine at 2, 4 and 6 months of age, two boosters at 18 months and 6 years, a booster dose of tetanus vaccine every 10 years and two doses during pregnancy. To evaluate the effect of this schedule, antibodies against pertussis toxin (PT) and filamentous hemagglutinin (FHA) and against tetanus and diphtheria toxoids were determined by ELISA in serum samples from children (1 month to 6 years) who received different doses of DPT vaccine: 0 dose (n = 50), 1 dose (n = 25), 2 doses (n = 25), 3 doses (n = 55), first and second booster (n = 25); 25 pregnant women and their offspring, and 45 adults. High antibody levels against PT (> 140 EU/ml) and FHA (> 80 EU/ml) were recorded in mothers and in the newborn. Antibody titers against PT increased with the number of doses given and decreased with time. Full protection against tetanus (titers > 0.1 IU/ml) was observed in the group of adults (0.37 IU/ml), in mothers (4.4 IU/ml) and their newborn offspring (5.5 IU/ml), and in children after receiving the second dose of DTP vaccine (1.86 IU/ml). The immune status for diphtheria was far lower, as most of the groups lacked adequate protection. After the third dose of DTP vaccine, only 78% of the children had antibody titers above the protective level (0.1 IU/ml). Since antibody levels considered to provide full protection were only achieved after the first booster dose of DTP vaccine, the primary three-dose schedule seems to be insufficient to confer adequate immunity in all vaccinees. Because of the high proportion of non-protected adults, a booster dose of Td vaccine should be considered for this group.

Prevalence of hyperimmunization against tetanus in a national sample of 18–26 year old immune subjects in Italy

Prevalence of tetanus hyperimmunization was estimated among 3217 immune subjects to be approximately equal to 11%. Hyperimmunization was associated with age, area of residence and health care availability. Indiscriminate administration of booster doses of tetanus vaccine could result in some areas in unnecessary revaccinations and possibly hypersensitivity reactions. The immunization policy regarding booster doses should be based on factual evidence and not on rigid recommendations.

In Reply: Reactions to Booster Doses of Tetanus Vaccine

Dr. Perez-Martin's problem regarding reactions to booster doses of tetanus toxoid is one that has concerned many physicians. Excluding those reactions due to pertussis or diphtheria antigens in combined preparations, most appear to fall into one of three patterns: apparent true allergy with urticaria, a severe local reaction (Arthus phenomenon) with or without systemic symptoms, and unpleasant, generalized fever and malaise of several days' duration. The problem has recently been superbly discussed by Edsall and others (J.A.M.A, 202:17, 1967).