Authors
Porter JD. Perkin MA. Corbel MJ. Farrington CP. Watkins JT. Begg NT.
Institution
Public Health Laboratory Service, Communicable Disease Surveillance Centre,
London, UK.
Title
Lack of early antitoxin response to tetanus booster.
Source
Vaccine. 10(5):334-6, 1992.
Abstract
Tetanus immune globulin (TIG) continues to be recommended in persons with
tetanus-prone wounds who have incomplete or unknown tetanus immunization
status. The aim of this study was to determine whether, following a booster
dose of tetanus toxoid in adults who had not been immunized in the previous
10 years, there was an antitoxin response to tetanus toxoid booster within 4
days. Thirty-one adults were investigated, baseline levels for tetanus
antitoxin assayed using an ELISA technique, and an injection of adsorbed
tetanus toxoid (0.5 ml) given. Blood samples for tetanus antitoxin levels
were taken at daily intervals for the 4 days following immunization. Tetanus
boosters following the primary course but before the present study did not
significantly increase the levels of pre-study tetanus antitoxin and
following the study booster there was no difference between the preboost
levels and the levels on days 1 to 4. This finding indicates that the
present recommendations for the use of TIG in tetanus-prone wounds are
appropriate.
Putting these two papers together it would seem that a booster given to a
patient following a previous completed primary immunisation will get an
adequate antibody levels by 4 days but if the immunisation is incomplete or
unknown then a booster won't give adequate cover.
Ray McGlone
----- Original Message -----
From: "Ray McGlone" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, May 21, 2004 11:34 PM
Subject: Tetanus
> I was wondering what people were doing on the ground regarding tetanus
> immunisation. We hadn't had a tetanus case in our area for over 20 years
> until one case last year and now another one this year. The last case was
a
> 35 yr old who had had 5 boosters last one being as a teenager (full
course),
> the person developed tetanus about two weeks after a thorn injury whilst
> gardening. The person did not attend A&E at the time of the injury.
>
> But on the current advice (enclosed) she would not have been offered a
> tetanus booster if she had attended A&E. I must admit that I still offer a
> booster if the wound is "tetanus prone" if they have not had a booster
> within 10 years. In the study below adequate circulating levels of
antitoxin
> were acheived within 4 days of the booster.
>
> What do other people do?
>
> Ray McGlone
> A&E Lancaster
>
> Authors
> Simonsen O. Kjeldsen K. Heron I.
>
> Title
> Immunity against tetanus and effect of revaccination 25-30 years after
> primary vaccination.
>
> Source
> Lancet. 2(8414):1240-2, 1984 Dec 1.
>
> Local Messages
> Held at BMA Library
>
> Abstract
> Fall off in tetanus immunity and the effect of late revaccination were
> investigated in a randomly selected group of Danes aged 25-30. Routine
> reinforcing doses of tetanus toxoid are not customary in Denmark except at
> injury and when there are certain occupational risks. 11% of the total
group
> of 418 had antitoxin titres below that required for protection (ie, less
> than 0.01 IU/ml, determined by neutralisation technique). In those who had
> received only primary vaccination an exponential fall off in immunity was
> seen, and 25-30 years after primary vaccination, 28% had serum antitoxin
> concentrations below the level of protection. Up to 30 years after primary
> vaccination, one reinforcing dose of tetanus toxoid adsorbed by aluminium
> hydroxide was sufficient to induce protective titres of antitoxin. There
> were no serious side-effects and it was concluded that routine reinforcing
> doses of tetanus toxoid should be given before the age of 20 in Denmark
and
> other countries where primary vaccination is given in the first years of
> life.
>
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