Serologic Immunity to Diphtheria and Tetanus in the United States
In general, childhood immunization is a public health
success story in the U.S., with strong coverage of all the key
vaccine-preventable diseases. However, immunizations for adolescents
and adults have not been as successful. A recent CDC study reports
that an alarming number of adults (53%) lack protective levels
of antibodies against both tetanus and diphtheria. The study by
Geraldine McQuillan, PhD, and her colleagues reviewed blood samples
from 18,045 people who had taken part in the National Health and
Nutrition Examination Survey between 1988 and 1994 to determine
immunity among the general public. Although tetanus and diphtheria
are relatively rare diseases in the U.S. today, the authors voice
concerns that they could become larger problems if we let our guard
down. McQuillan, et al., remind health professionals how important
it is to make sure patients are protected with up-to-date immunizations.
Tetanus and Diphtheria Immunity among Females in the United States: Are Recommendations Being Followed?
A study in the April 2004 issue of the American Journal of Obstetrics and Gynecology looked at serologic level of tetanus and diphtheria antitoxins in 9,411 females ages six years and older. The researchers also reviewed blood samples from NHANES. The study found that 57% and 64% of female subjects ages six years and older were positive for diphtheria and tetanus toxins, respectively, but that only 41% of women ages 20 years and older were protected against both; protective levels in these women were lower than that of the general population ages 20 and older (47%). Older age, birth outside the U.S. and less education was associated with lower immunity.
The authors suggest that all physicians, including obstetricians and gynecologists who may be the sole medical providers for women, should be familiar with the current Advisory Committee on Immunization Practices recommendations regarding tetanus and diphtheria toxoid booster vaccines.
- Tetanus and Diphtheria Immunity among Females in the United States: Are Recommendations Being Followed?
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