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参与自愿献血计划,以此作为评估和增强疫苗接种状态过期或不明的成年献血者破伤风免疫力的契机。

Participation in a Voluntary Blood Donation Program as an Opportunity to Assess and Enhance Tetanus Immunity in Adult Blood Donors with an Outdated or Unknown Vaccination Status.

作者信息

Tkaczyszyn Katarzyna, Szymczyk-Nużka Małgorzata, Szenborn Leszek

机构信息

Clinical Department of Paediatrics and Infectious Diseases, Faculty of Medicine, Wroclaw Medical University, Chalubinskiego 2-2A Str., 50-368 Wroclaw, Poland.

Regional Blood Transfusion Center, Czerwonego Krzyża 5/9 Str., 50-345 Wroclaw, Poland.

出版信息

Vaccines (Basel). 2025 Aug 21;13(8):884. doi: 10.3390/vaccines13080884.

Abstract

Booster vaccination coverage in the adult population in Poland remains insufficient. The objective of this study was to utilize the opportunity of a visit to the Regional Blood Transfusion Center in Wroclaw-associated with blood donation-as a means to remind individuals about the need for tetanus booster vaccination and to assess tetanus immunity in healthy adults (30-40 years after their last mandatory dose) who had not received booster immunizations. : A total of 97 blood donors aged 50 to 64 years (median age: 54 years) were enrolled, of whom 78% were male. 1. Tetanus immunity was assessed by a single measurement of serum anti-tetanus IgG antibody concentration. 2. A questionnaire was used to collect data relevant to tetanus immune status. 3. Individuals with insufficient protection received a booster dose of the tetanus vaccine, and the post-vaccination serologic response was evaluated. 1. In the study group, 10.3% of participants had no protective immunity against , while 5.2% exhibited uncertain protection. An additional 32% demonstrated antibody levels conferring only short-term protection. Satisfactory protection-defined as immunity lasting at least 3 years-or long-term protection (at least 5 years) was identified in 52.5% of patients. Although 72% of donors reported receiving mandatory childhood immunizations, only 5% could provide medical documentation. In this subgroup, a significantly higher geometric mean antibody concentration was observed (0.69 vs. 0.52 IU/mL; = 0.04), and significantly fewer participants required immediate post-exposure prophylaxis (1/39 vs. 14/54; = 0.003). 2. Among the 46 individuals eligible for a booster dose, 17 (37%) returned for vaccination. Of these, 16 (94%) achieved antibody titers consistent with long-term protection following a single vaccine dose. : Tetanus immunity among adults is heterogeneous and difficult to predict due to the frequent lack of vaccination records and unreliable self-reported histories. A history of injury and associated surgical wound care involving injection often serves as the only indication of prior vaccination. A single booster dose is highly effective in eliciting a robust immune response in individuals vaccinated during childhood but lacking recent boosters. Rising vaccine hesitancy toward both mandatory and recommended immunizations in Poland negatively influences adult decisions regarding tetanus vaccination. Participation in voluntary blood donation programs presents a valuable opportunity for immunization education, immune status screening, and the implementation of effective catch-up vaccination strategies.

摘要

波兰成年人群体中的加强疫苗接种覆盖率仍然不足。本研究的目的是利用前往弗罗茨瓦夫地区输血中心(与献血相关)的机会,提醒人们注意破伤风加强疫苗接种的必要性,并评估未接受加强免疫的健康成年人(在最后一剂强制接种疫苗30 - 40年后)的破伤风免疫力。:总共招募了97名年龄在50至64岁之间(中位年龄:54岁)的献血者,其中78%为男性。1. 通过单次测量血清抗破伤风IgG抗体浓度来评估破伤风免疫力。2. 使用问卷收集与破伤风免疫状态相关的数据。3. 对保护不足的个体接种一剂破伤风疫苗加强针,并评估接种后的血清学反应。1. 在研究组中,10.3%的参与者对破伤风没有保护性免疫力,而5.2%表现出不确定的保护作用。另外32%的人抗体水平仅提供短期保护。52.5%的患者具有令人满意的保护作用(定义为免疫力持续至少3年)或长期保护(至少5年)。尽管72%的献血者报告接受过儿童期强制免疫接种,但只有5%能提供医疗记录。在这个亚组中,观察到几何平均抗体浓度显著更高(0.69对0.52 IU/mL;P = 0.04),并且需要立即进行暴露后预防的参与者显著更少(1/39对14/54;P = 0.003)。2. 在46名有资格接种加强针的个体中,17人(37%)回来接种。其中,16人(94%)在接种一剂疫苗后抗体滴度达到了与长期保护一致的水平。:由于经常缺乏疫苗接种记录且自我报告的病史不可靠,成年人中的破伤风免疫力存在异质性且难以预测。受伤史以及涉及注射的相关手术伤口护理往往是既往接种疫苗的唯一指征。单次加强针在引发童年时期接种过疫苗但近期未接种加强针的个体产生强烈免疫反应方面非常有效。波兰对强制和推荐免疫接种的疫苗犹豫情绪上升,对成年人关于破伤风疫苗接种的决定产生了负面影响。参与自愿献血项目为免疫教育、免疫状态筛查以及实施有效的补种疫苗策略提供了宝贵机会。

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