Durability of Vaccine-Induced Immunity Against Tetanus and Diphtheria Toxins: A Cross-sectional Analysis

Erika Hammarlund, Archana Thomas, Elizabeth A. Poore, Ian J. Amanna, Abby E. Rynko, Motomi (Tomi) Mori, Zunqiu Chen, Mark Slifka

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Many adult immunization schedules recommend that tetanus and diphtheria vaccination be performed every 10 years. In light of current epidemiological trends of disease incidence and rates of vaccine-associated adverse events, the 10-year revaccination schedule has come into question. Methods. We performed cross-sectional analysis of serum antibody titers in 546 adult subjects stratified by age or sex. All serological results were converted to international units after calibration with international serum standards. Results. Approximately 97% of the population was seropositive to tetanus and diphtheria as defined by a protective serum antibody titer of ≥0.01 IU/mL. Mean antibody titers were 3.6 and 0.35 IU/mL against tetanus and diphtheria, respectively. Antibody responses to tetanus declined with an estimated half-life of 14 years (95% confidence interval, 11-17 years), whereas antibody responses to diphtheria were more long-lived and declined with an estimated half-life of 27 years (18-51 years). Mathematical models combining antibody magnitude and duration predict that 95% of the population will remain protected against tetanus and diphtheria for ≥30 years without requiring further booster vaccination. Conclusions. These studies demonstrate that durable levels of protective antitoxin immunity exist in the majority of vaccinated individuals. Together, this suggests that it may no longer be necessary to administer booster vaccinations every 10 years and that the current adult vaccination schedule for tetanus and diphtheria should be revisited.

Original languageEnglish (US)
Pages (from-to)1111-1118
Number of pages8
JournalClinical Infectious Diseases
Volume62
Issue number9
DOIs
StatePublished - May 1 2016

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Tetanus Toxin
Diphtheria Toxin
Diphtheria
Tetanus
Immunity
Vaccines
Cross-Sectional Studies
Vaccination
Antibodies
Antibody Formation
Half-Life
Appointments and Schedules
Serum
Immunization Schedule
Antitoxins
Secondary Immunization
Calibration
Population
Theoretical Models
Confidence Intervals

Keywords

  • cross-sectional analysis
  • diphtheria
  • immunological memory
  • Tetanus

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Durability of Vaccine-Induced Immunity Against Tetanus and Diphtheria Toxins : A Cross-sectional Analysis. / Hammarlund, Erika; Thomas, Archana; Poore, Elizabeth A.; Amanna, Ian J.; Rynko, Abby E.; Mori, Motomi (Tomi); Chen, Zunqiu; Slifka, Mark.

In: Clinical Infectious Diseases, Vol. 62, No. 9, 01.05.2016, p. 1111-1118.

Research output: Contribution to journalArticle

Hammarlund, Erika ; Thomas, Archana ; Poore, Elizabeth A. ; Amanna, Ian J. ; Rynko, Abby E. ; Mori, Motomi (Tomi) ; Chen, Zunqiu ; Slifka, Mark. / Durability of Vaccine-Induced Immunity Against Tetanus and Diphtheria Toxins : A Cross-sectional Analysis. In: Clinical Infectious Diseases. 2016 ; Vol. 62, No. 9. pp. 1111-1118.
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