Travel and Migrant Health Section, Colindale, Health Protection Agency, London, NW9 5EQ, UK.
Vaccine. 2012 Nov 19;30(49):7111-7. doi: 10.1016/j.vaccine.2012.09.029. Epub 2012 Sep 26.
This study aimed to estimate the immunity of the UK population to tetanus and diphtheria, including the potential impact of new glycoconjugatate vaccines, and the addition of diphtheria to the school leaver booster in 1994.
Residual sera (n=2697) collected in England in 2009/10 were selected from 18 age groups and tested for tetanus and diphtheria antibody. Results were standardised by testing a panel of sera (n=150) to enable comparison with a previously (1996) published serosurvey. Data were then standardised to the UK population.
In 2009, 83% of the UK population were protected (≥0.1 IU/mL) against tetanus compared to 76% in 1996 (p=0.079), and 75% had at least basic protection against diphtheria (≥0.01 IU/mL) in 2009 compared to 60% in 1996 (p<0.001). Higher antibody levels were observed in those aged 1-3 years in 2009 compared to 1996 for both tetanus and diphtheria. Higher diphtheria immunity was observed in those aged 16-34 years in 2009 compared to 1996 (geometric mean concentration [GMC] 0.15 IU/mL vs. 0.03 IU/mL, p<0.001). Age groups with the largest proportion of susceptible individuals to both tetanus and diphtheria in 2009 were <1 year old (>29% susceptible), 45-69 years (>20% susceptible) and 70+ years (>32% susceptible). Low immunity was observed in those aged 10-11 years (>19% susceptible), between the scheduled preschool and school leaver booster administration.
The current schedule appears to induce protective levels; increases in the proportions protected/GMCs were observed for the ages receiving vaccinations according to UK policy. Glycoconjugate vaccines appear to have increased immunity, in particular for diphtheria, in preschool age groups. Diphtheria immunity in teenagers and young adults has increased as a result of the addition of diphtheria to the school leaver booster. However, currently older adults remain susceptible, without any further opportunities for immunisations planned according to the present schedule.
本研究旨在评估英国人群对破伤风和白喉的免疫力，包括新型糖结合疫苗的潜在影响，以及 1994 年在学校离校者加强针中加入白喉。
从英格兰 2009/10 年收集的剩余血清（n=2697）中选择了 18 个年龄组进行破伤风和白喉抗体检测。通过检测一组血清（n=150）对结果进行标准化，以使其能够与之前（1996 年）发表的血清学调查结果进行比较。然后，将数据标准化到英国人群。
2009 年，83%的英国人口对破伤风有保护作用（≥0.1 IU/mL），而 1996 年为 76%（p=0.079），2009 年 75%的人对白喉有至少基本的保护作用（≥0.01 IU/mL），而 1996 年为 60%（p<0.001）。2009 年，1-3 岁人群的破伤风抗体水平高于 1996 年。2009 年，16-34 岁人群对白喉的免疫力高于 1996 年（几何平均浓度[GMC] 0.15 IU/mL 与 0.03 IU/mL，p<0.001）。2009 年，对破伤风和白喉均易感的年龄组最大的是<1 岁（>29%易感）、45-69 岁（>20%易感）和 70+岁（>32%易感）。在 10-11 岁（>19%易感）的年龄组中观察到免疫水平较低，这一阶段介于计划中的学前和学校离校者加强针接种之间。
目前的时间表似乎能诱导出保护水平；根据英国政策，接受疫苗接种的年龄组的保护比例/GMC 均有所增加。糖结合疫苗似乎增加了学龄前儿童对白喉的免疫力。由于在学校离校者加强针中加入了白喉，青少年和年轻成年人对白喉的免疫力有所提高。然而，目前的成年人仍然易感，按照目前的时间表，没有进一步的免疫接种计划。
