破伤风免疫作为外来移民儿童既往白喉-破伤风-百日咳疫苗接种的替代指标。
Tetanus immunity as a surrogate for past diphtheria-tetanus-pertussis immunization in migrant children.
机构信息
Division of General Pediatrics, Department of Pediatrics, University Hospitals of Geneva and University of Geneva Medical School, Geneva, Switzerland.
出版信息
Pediatr Infect Dis J. 2013 Mar;32(3):274-7. doi: 10.1097/INF.0b013e3182748f0b.
BACKGROUND
Data on vaccination coverage in recently arrived refugee children are essential to formulate catch-up recommendations. "Overimmunizing" is costly and associated with risks of hyperimmunization, whereas assuming up-to-date immunizations may be misleading.
METHODS
We retrospectively collected data from 92 migrant children referred to our hospital between January 2009 and May 2010.
RESULTS
According to our guidelines, 68 (73.9%) children without evidence of up-to-date immunizations received a booster dose of an age-appropriate tetanus-containing vaccine. As a surrogate for diphtheria-tetanus-pertussis-poliomyelitis immunity, tetanus antibodies were measured by enzyme-linked immunosorbent assay 1 month later in 55 of 68 (80.8%) children 6 months to 16 years of age (median, 7 years) from 23 countries. All but 2 children (3.6%) had reached high antibody titers (>1.0 IU/mL) and required no further booster. Unnecessary additional tetanus immunizations thus were avoided in 53 of 55 (96.4%) patients.
CONCLUSION
Assessing antitetanus antibody responses in migrant children allows individual vaccination schedules and avoids the risks of hyperimmunization.
背景
了解最近抵达的难民儿童的疫苗接种覆盖率对于制定追赶免疫建议至关重要。过度免疫既昂贵又有导致超敏反应的风险，而假设免疫是最新的可能会产生误导。
方法
我们回顾性地收集了 2009 年 1 月至 2010 年 5 月期间 92 名转诊到我们医院的移民儿童的数据。
结果
根据我们的指南，68 名（73.9%）没有最新免疫证据的儿童接受了一剂适龄含破伤风疫苗的加强针。为了替代白喉-破伤风-百日咳-脊髓灰质炎免疫，我们用酶联免疫吸附试验测量了 68 名（80.8%）6 个月至 16 岁（中位数 7 岁）来自 23 个国家的儿童 1 个月后的破伤风抗体。除了 2 名儿童（3.6%）外，所有儿童的抗体滴度都很高（>1.0 IU/mL），不需要进一步加强免疫。因此，在 55 名儿童（96.4%）中避免了不必要的额外破伤风免疫。
结论
评估移民儿童的破伤风抗体反应可以制定个体化的疫苗接种计划，避免超敏反应的风险。
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