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Discrepancies between Vaccine Documentation and Serologic Status for Diphtheria, Tetanus, and Hepatitis B in
Angela Bechini1, Sara Boccalini1, Ilaria Rancan2
1Department of Health Sciences, University of Florence, 50134 Florence, Italy.
Insights
Internationally Adopted Children (IAC) often have incomplete immunisation coverage. A study found significant discrepancies between vaccine records and actual antibody titres, especially for hepatitis B, emphasizing the need for thorough assessment.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- Internationally Adopted Children (IAC) frequently present with suboptimal immunisation coverage.
- Existing data on IAC immunisation status are often inconsistent.
Purpose of the Study:
- To evaluate the immunisation status against diphtheria, tetanus, and hepatitis B in IAC.
- To identify risk factors associated with seronegativity in this population.
Main Methods:
- Analysis of data from 2073 IAC evaluated at Meyer Children's University Hospital (2009-2019).
- Assessment of antibody titres for diphtheria, tetanus, and hepatitis B.
- Multivariate analysis to identify factors associated with immunisation status.
Main Results:
- 11.5% of IAC showed negative diphtheria titres, 18.6% for tetanus, and 39.0% for hepatitis B.
- Originating from Africa was a risk factor for seronegativity for all three diseases.
- A notable discrepancy exists between vaccine documentation and serological evidence of immunity.
Conclusions:
- Vaccine documentation alone is insufficient to confirm protective immunity in IAC.
- A comprehensive immunisation status assessment is crucial, particularly for IAC from Africa and those over four years old.
Abstract:
Internationally Adopted Children (IAC) often show suboptimal immunisation coverage, but available data are discordant. Data at the first evaluation of 2073 IAC (median age: 6 years) referred to the Meyer Children's University Hospital (Florence, Italy) in 2009-2019 were analysed in order to evaluate their immunisation status against diphtheria, tetanus, and hepatitis B. Negative antibody titres were observed in 11.5% of the IAC for diphtheria, 18.6% for tetanus, and 39.0% for hepatitis B. At multivariate analysis, originating from Africa was an independent risk factor for seronegativity for the three diseases (p < 0.001), while age below four years was an independent factor associated with protective immunity, only considering hepatitis B (p < 0.001). Vaccine documentation was an additional factor independently associated with protective immunity. However, a discrepancy between documentation (indicating previous vaccinations) and serology (showing negative antibody titres) was evidenced in 3.8% of the children for diphtheria, 12.6% for tetanus, and 29.6% for hepatitis B. This finding suggests that although vaccine documentation may reflect the presence of protective antibody titres, it should not be accepted as absolute evidence of protective immunity, underlining the importance of a complete assessment of immunisation status in IAC, particularly in those originating from Africa and aged over four years.
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