Dinelli M I S, Fisberg M, de Moraes-Pinto M I
Departamento de Pediatria, Universidade Federal de São Paulo, Rua Pedro de Toledo 781, 04039-032 São Paulo, SP, Brazil.
Braz J Med Biol Res. 2007 Feb;40(2):259-63. doi: 10.1590/s0100-879x2007000200013.
Tetanus and diphtheria vaccines are of special concern in adolescents because boosters are necessary for adequate maintenance of protection and are often omitted. We assessed serum levels of tetanus and diphtheria antibodies in adolescents and their association with vaccination status. From May to October 2001, we evaluated the vaccination records of 208 adolescents aged 10 to 20 years in São Paulo, Brazil. Antibodies to tetanus and diphtheria were detected using double-antigen ELISA and vaccination records were analyzed according to the guidelines of the Brazilian National Immunization Program. All adolescents had received complete primary vaccinations against tetanus and diphtheria, but 23.1% of them had not received a booster dose in the last 10 years. All adolescents were immune to tetanus and 88.9% were fully protected (antibodies (3)0.1 IU/mL). One individual (0.5%) was non-immune to diphtheria and 86% were fully protected against the disease. Adolescents with up-to-date vaccination records had higher antibody levels than those with not up-to-date records for tetanus (0.763 vs 0.239 IU/mL, t-test: P < 0.0001) and diphtheria (0.366 vs 0.233 IU/mL, t-test: P = 0.014). Full immunity against tetanus (antibodies (3)0.1 IU/mL) was higher among individuals with up-to-date vaccination (93.1%) when compared to those with not up-to-date records (75%, Fisher's exact test: P = 0.001). All adolescents had received basic immunization in childhood and were protected against tetanus and diphtheria. However, these data indicate that more emphasis should be placed on the tetanus-diphtheria booster in order to avoid a decay in antibody levels.
破伤风和白喉疫苗在青少年中备受关注，因为需要接种加强针来充分维持免疫力，但加强针常常被遗漏。我们评估了青少年破伤风和白喉抗体的血清水平及其与疫苗接种状况的关联。2001年5月至10月，我们评估了巴西圣保罗208名10至20岁青少年的疫苗接种记录。采用双抗原ELISA法检测破伤风和白喉抗体，并根据巴西国家免疫规划指南分析疫苗接种记录。所有青少年都完成了针对破伤风和白喉的基础免疫接种，但其中23.1%的人在过去10年中未接种加强针。所有青少年对破伤风均有免疫力，88.9%的人得到了充分保护（抗体≥0.1 IU/mL）。有1人（0.5%）对白喉无免疫力，86%的人对白喉有充分保护。疫苗接种记录最新的青少年破伤风抗体水平（0.763 vs 0.239 IU/mL，t检验：P < 0.0001）和白喉抗体水平（0.366 vs 0.233 IU/mL，t检验：P = 0.014）高于记录不最新的青少年。疫苗接种记录最新的个体中，对破伤风的完全免疫（抗体≥0.1 IU/mL）率为93.1%，高于记录不最新的个体（75%，Fisher精确检验：P = 0.001）。所有青少年在儿童期都接受了基础免疫，对破伤风和白喉有保护作用。然而，这些数据表明，应更加强调破伤风-白喉加强针接种，以避免抗体水平下降。
