Tanriover Mine Durusu, Soyler Canan, Ascioglu Sibel, Cankurtaran Mustafa, Unal Serhat
Hacettepe University Faculty of Medicine, Department of Internal Medicine, Section of General Internal Medicine, 06100, Sıhhiye, Ankara, Turkey.
Hacettepe University Faculty of Medicine, Department of Internal Medicine, Section of General Internal Medicine, 06100, Sıhhiye, Ankara, Turkey.
Eur J Intern Med. 2014 Jul;25(6):528-32. doi: 10.1016/j.ejim.2014.04.010. Epub 2014 May 9.
Tetanus, diphtheria, pertussis and measles are vaccine preventable diseases that have been reported to cause morbidity and mortality in adult population in the recent years. We aimed to document the seropositivity rates and vaccination indication for these four vaccine preventable diseases among adult and elderly patients who were seen as outpatients in a university hospital.
Blood samples for tetanus, diphtheria, pertussis and measles antibodies were obtained. Results were evaluated with regards to protection levels and booster vaccine indications according to the cut-off values.
A total of 1367 patients consented for the study and 1303 blood samples were available for analysis at the end of the study. The antibody levels against measles conferred protection in 98% of patients. However, 65% of the patients had no protection for diphtheria, 69% had no protection for tetanus and 90% of the patients had no protection for pertussis. Only 1.3% of the study population had seropositivity against three of the diseases-Tdap booster was indicated in 98.7%. Multivariable logistic regression showed that tetanus protection decreased with increasing age. Having a chronic disease was associated with a lower rate of protective antibodies for pertussis.
We demonstrated very low rates of protection against three of the vaccine preventable diseases of childhood-diphtheria, pertussis and tetanus. Booster vaccinations are required in adult life in accordance with national and international adult vaccination guidelines. The concept of "lifelong vaccination" should be implemented and every encounter with the patient should be regarded as a chance for catch-up.
破伤风、白喉、百日咳和麻疹是疫苗可预防疾病，近年来有报道称这些疾病在成人中会导致发病和死亡。我们旨在记录在一所大学医院门诊就诊的成年和老年患者中这四种疫苗可预防疾病的血清阳性率和疫苗接种指征。
采集破伤风、白喉、百日咳和麻疹抗体的血样。根据临界值，就保护水平和加强疫苗指征对结果进行评估。
共有1367名患者同意参与本研究，研究结束时1303份血样可供分析。98%的患者体内抗麻疹抗体水平具有保护作用。然而，65%的患者对白喉没有保护作用，69%的患者对破伤风没有保护作用，90%的患者对百日咳没有保护作用。仅1.3%的研究人群对三种疾病血清呈阳性——98.7%的患者需要接种破伤风类毒素、白喉、无细胞百日咳联合疫苗（Tdap）加强针。多变量逻辑回归显示，破伤风保护作用随年龄增长而降低。患有慢性病与百日咳保护性抗体水平较低相关。
我们发现针对儿童期三种疫苗可预防疾病——白喉、百日咳和破伤风的保护率非常低。应根据国家和国际成人疫苗接种指南在成年期进行加强接种。应实施“终身接种”的理念，每次与患者接触都应视为补种的机会。
