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Persistence of antibody after accelerated immunisation with diphtheria/tetanus/pertussis vaccine
M E Ramsay1, M J Corbel, K Redhead
1PHLS Communicable Disease Surveillance Centre, Colindale, London.
Insights
An accelerated diphtheria, tetanus, and pertussis (DTaP) vaccine schedule completed before six months of age provides persistent antibody levels. This early immunisation ensures adequate protection against these diseases until preschool boosters are administered.
Area of Science:
- Pediatric Immunology
- Vaccinology
- Infectious Disease Prevention
Background:
- Antibody persistence following childhood immunisation is crucial for long-term protection.
- Evaluating accelerated vaccination schedules is important for optimizing public health strategies.
Purpose of the Study:
- To assess the antibody persistence of diphtheria, tetanus, and pertussis (DTaP) in children who received an accelerated primary immunisation schedule.
- To compare antibody levels in children receiving early versus later completion of the DTaP primary series.
Main Methods:
- A controlled study involving antibody testing of blood samples from 129 children aged 4 years.
- Children received varying schedules of the DTaP vaccine, with some completing the primary series before 6 months of age.
- Measurements included diphtheria and tetanus antitoxin concentrations and antibody titres to pertussis components.
Main Results:
- All children demonstrated protective antibody concentrations for diphtheria and tetanus.
- No significant difference in diphtheria or tetanus antitoxin levels, or pertussis antibody titres, was observed between accelerated and standard schedules.
- Antibody levels remained protective, indicating successful immunisation regardless of the schedule's completion time.
Conclusions:
- Completing the three-dose DTaP primary immunisation series before 6 months of age likely ensures adequate protection against diphtheria, tetanus, and pertussis.
- The observed antibody persistence suggests that this accelerated schedule provides protection until the preschool booster dose.
- Early childhood immunisation schedules can be effective in establishing lasting immunity.
Objective:
To determine the persistence of antibody to diphtheria, tetanus, and pertussis in children receiving an accelerated schedule of primary immunisation.
Design:
Controlled study of antibody testing of blood samples from children immunised according to various schedules: three doses of triple vaccine completed at 8-13 calendar months, 6-7 calendar months, before 6 calendar months, or three doses followed by diphtheria/tetanus before age 2.
Setting:
Plymouth Health Authority.
Subjects:
129 children aged 4 years who had received three doses of diphtheria/tetanus/pertussis vaccine with or without a diphtheria/tetanus booster.
Main Outcome Measures:
Diphtheria and tetanus antitoxin concentrations and antibody titres to pertussis toxin, filamentous haemagglutinin, and agglutinogens 2 and 3.
Results:
All children had protective concentrations of antitoxin to diphtheria and tetanus (greater than or equal to 0.01 IU/ml). There was no evidence of a significant difference in diphtheria or tetanus antitoxin concentrations and pertussis antibody titres in children immunised with an accelerated course (third dose of triple vaccine before 6 months) compared with those who received a longer course (third dose at 8-13 months) with no booster (geometric mean antitoxin concentration 0.411 (95% confidence interval 0.273 to 0.618) v 0.426 (0.294 to 0.616) for diphtheria and 0.358 (0.231 to 0.556) v 0.299 (0.197 to 0.453) for tetanus; geometric mean antibody titres 903 (500 to 1631) v 1386 (848 to 2266) for pertussis filamentous haemagglutinin, 179 (130 to 248) v 232 (167 to 322) for pertussis toxin, and 2002 (1276 to 3142) v 3591 (2220 to 5809) for agglutinogens 2 and 3).
Conclusion:
Immunisation with three doses of triple vaccine at monthly intervals completed before 6 months of age probably provides adequate protection against diphtheria, tetanus, and whooping cough which will persist until the age of the preschool booster.