Reactions and antibody responses to reinforcing doses of adsorbed and plain tetanus vaccines

In children aged 15--16 years receiving routine reinforcement tetanus immunisation, adsorbed vaccine caused more severe and more frequent local reactions than did plain formol toxoid, and a higher incidence of pyrexia. The incidence of swelling and erythema at the inoculation site increased with serum antitoxin titre at the time of inoculation, whereas pain and tenderness were related to the presence of the aluminium hydroxide adjuvant. Both vaccines gave satisfactory antibody responses over a 5-month observation period; plain formol toxoid induced higher mean titres than did the adsorbed vaccine. It is recommended that plain and not adsorbed vaccine be used when reinforcement of immunity to tetanus alone is desired.