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[Sex and age-dependent gaps in tetanus immunization]
1Institut für Immunologie und Transfusionsmedizin, Medizinischen Universität Lübeck.
Insights
Tetanus immunity is insufficient in many individuals, particularly women and children. This study reveals low tetanus antitoxin levels and inadequate protection across various age groups, highlighting critical public health concerns.
Area of Science:
- Immunology
- Epidemiology
Context:
- Tetanus remains a preventable disease, yet immunity levels vary significantly within populations.
- Assessing tetanus antitoxin titres is crucial for evaluating population-level protection.
Purpose:
- To evaluate tetanus immunity status across a diverse age range.
- To identify demographic factors influencing tetanus protection.
Summary:
- A study of 692 individuals found 15.5% had inadequate tetanus protection (titre < 0.1 IU/ml).
- Females, especially those 20 and older, showed significantly lower average antitoxin titres than males.
- Inadequate maternal immunity impacted newborns, and 18% of children aged 1-15 years lacked sufficient protection.
Impact:
- Highlights a need for targeted tetanus booster campaigns, particularly for women and children.
- Underscores the importance of monitoring tetanus immunity in public health surveillance.
- Reveals potential intergenerational transmission of inadequate tetanus immunity.
Abstract:
To test tetanus immunity, tetanus antitoxin titres were measured in the serum of 692 subjects (354 males, 338 females), aged one day (newborns) to 92 years (mean age 29 years). Those aged 18 to 65 years were first-time blood donors, the remainder were healthy newborns, while the children and those over 65 years were patients without immune-compromising disease. An inadequate protection (titre < 0.1 IU/ml) was found in 107 (15.5%), of whom 75 (70%) were females. Women aged 20 years and above also had significantly lower average antitoxin titres than men (1.7 vs. 3.5 IU/ml); P < 0.0001). The inadequate immunization protection of many young women is reflected in the lack of protective antibodies in 10 of the 49 examined newborns. In addition, 18% of children aged between 1 and 15 years had inadequate immunity against tetanus. In the whole group the titre level decreased with age, while the proportion of unprotected persons increased. Apart from the obvious age and sex dependency of the demonstrated inadequacy of immunological protection against tetanus, attention should also be paid to the lack of protective antibodies in newborns and the marked gaps of immunity among children.