Vaccine
Volume 37, Issue 43, 2019, Pages 6441-6446
Single doses of diphtheria-tetanus-pertussis and poliomyelitis vaccines are sufficient to generate a booster-type response to tetanus in most migrant children (Article)
Fougère Y.* ,
El Houss S. ,
Suris J.-C. ,
Rouvenaz-Defago S. ,
Miletto D. ,
Von der Weid L. ,
Willen F. ,
Williams-Smith J.A. ,
Gehri M. ,
Crisinel P.A.
-
a
Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland
-
b
Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland
-
c
Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland
-
d
Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland
-
e
Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland
-
f
Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland
-
g
Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland
-
h
Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland
-
i
Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland
-
j
Unit of Pediatric Infectious Diseases and Vaccinology, Department Women-Mother-Child, Lausanne University Hospital, Switzerland
Abstract
Background: Immunization coverage for three doses of the diphtheria-tetanus-pertussis and poliomyelitis vaccines in infants is high worldwide, therefore despite the lack of documentation of past vaccinations, most migrant children do not require complete revaccination. Our strategy was to administer a single dose of a tetanus toxoid containing vaccine (TTCV) to migrant children followed by anti-tetanus toxoid (TT) serology to determine whether additional vaccine doses were required. Our goal was to estimate the basic TTCV coverage and to identify potential determinants of the vaccination response. Methods: Newly arrived migrant children were prospectively enrolled between October 2014 and August 2017. We included patients aged 1–18 years with no proof of past vaccinations who accepted a single dose of TTCV. Anti-TT serology was performed after 4–6 weeks, and an anti-TT level ≥ 1 IU/mL was considered a booster-type antibody response with no need for additional doses of TTCV. Potential determinants of the vaccination response were identified using univariate and multivariate linear regression analyses. Results: Two hundred and eight children were eligible for analysis. The mean age of the children was 9 (±4.5) years and 100 (48%) were female. The majority (n = 129, 62%) of the children came from the WHO Eastern Mediterranean region. Only three patients (1.4%) required additional vaccine doses. A Syrian origin (p < 0.001) and direct arrival primarily by airplane into Switzerland without transiting through other European countries (p = 0.029) associated with higher anti-TT levels in a multivariate regression model (multiple r2 = 0.210, p < 0.001). Conclusion: A single dose of TTCV is enough to generate long-term protection in most migrant children. In the context of high basic vaccination coverage, the strategy, which consists of administration of a single dose of TTCV followed by anti-TT serology, can be considered where serotesting is available and economical. © 2019 Elsevier Ltd
Author Keywords
Index Keywords
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85072062704&doi=10.1016%2fj.vaccine.2019.08.089&partnerID=40&md5=c5f98f34997648b8f63d1dad72a9c7ad
DOI: 10.1016/j.vaccine.2019.08.089
ISSN: 0264410X
Original Language: English