OBJECTIVETo investigate the immunity level of diphtheria antibody among children living in the areas where different coverage rates of 4-vaccines stratified by results of national immunization program (NIP) reviewed in 2004.

METHODSAccording to data from 4-vaccine coverage rates of NIP reviewed in 2004, 3 levels could be set. We randomly selected 2 counties at each level and then 10 villages from each county with 42 children involved who were born between 1992 and 2003. ELISA quantitative method was used to test IgG of diphtheria antitoxin.

RESULTS(1) The positive rate of diphtheria antitoxin was only 49.6% with the highest as 78.1% and lowest as 33.0%. There was a significant decreasing trend of this positive rate with the increase of age. The highest (61.2%) fell in the group that were born in 2003 and the lowest (37.6%) was seen among children born in 1992 to 1995. (2) Geometric mean concentrations (GMCs) was only 0.48 IU/ml with a trend of decrease when age was increasing. There was no GMCs peak seen in children who were at the age of boosting, as expected. (3) Positive rates of children born between 2001 and 2003 were lower than 62% while the diphtheria-pertussis-tetanus (DPT) vaccine coverage rates were all higher than 90%. (4) There was no significant difference of diphtheria antitoxin positive rates between children with eligible routine immunization (58.1%) and those were ineligible (59.6%).

CONCLUSIONOther than some specific ones, children from most of the investigated counties had a low level of antibody against diphtheria. The coverage rate of DPT vaccine did not necessarily reflect the immunity against diphtheria, suggesting the increase of immunity against diphtheria an urgent task to be taken care of.

Adolescent ; Age Distribution ; Antibodies, Bacterial ; immunology ; Child ; Child, Preschool ; China ; Diphtheria ; immunology ; prevention & control ; Diphtheria Antitoxin ; immunology ; Diphtheria-Tetanus-Pertussis Vaccine ; immunology ; Female ; Humans ; Male

Objective: To analyze the dropout of adsorbed diphtheria, tetanus and acellular pertussis combined vaccine (DTaP) routine immunization in China in 2019. Methods: DTaP vaccination data in all counties in China were collected through National Immunization Program Information Management System in 2019. Cumulative dropout rate and vaccination rate of DTaP in different provinces were calculated. According to the P₂₅, P₅₀ and P₇₅ values of DTaP dropout rate for all counties by province, counties in each province were divided into four groups (Q₁-Q₄). The DTaP average dropout rate of four groups and absolute difference (difference in DTaP average dropout rate between Q₄ and Q₁) were calculated. Spearman rank correlation was used to analyze the relationship between absolute difference and provincial DTaP dropout rate, DTaP₁ and DTaP₃ vaccination rate. Results: DTaP₁ vaccination rate ranged from 92.98% to 99.94% by province, with a median of 99.55%. Provincial DTaP dropout rate ranged from 0.36% to 28.66%, with a median of 3.54%. The provincial DTaP dropout rate was more than 10% in Gansu and Guizhou, about 28.66% and 17.19%. Absolute difference ranged from 4.02% to 39.22%, with a median of 10.16%. Provinces with the largest absolute difference were Gansu, Qinghai, Liaoning and Guizhou, about 39.22%, 34.48%, 23.31% and 21.33%, respectively. Correlation analysis indicated that the absolute difference was positively correlated with provincial DTaP dropout rate, with a correlation coefficient of 0.492 (P=0.004). It was negatively correlated with DTaP₁ and DTaP₃ vaccination rate. Correlation coefficients were -0.542 (P=0.001) and -0.562 (P=0.001), respectively. Conclusions: There are significant county-level differences in DTap dropout rate in most provinces, with relatively high difference in western provinces.
Humans ; Infant ; Whooping Cough/prevention & control* ; Diphtheria-Tetanus-Pertussis Vaccine ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Vaccination ; China ; Immunization, Secondary ; Immunization Schedule ; Antibodies, Bacterial

This study was conducted to evaluate the immunogenicity and safety of diphtheria-tetanus (Td) vaccine in adults over 40 yr old who had never received a diphtheria-tetanus-pertussis (DTP) vaccination. A total of 242 subject completed three-doses of Td vaccination and subsequent assays for immunogenicity. Before vaccination, 33.9% and 96.7% participants showed antibody levels of diphtheria and tetanus, respectively, which were below protective level (<0.1 U/mL). After the first dose of Td vaccine, 92.6% and 77.6% of subjects gained protective antibody concentrations (> or =0.1 U/mL) for diphtheria and tetanus, with an increase to 99.6% and 100% after the third dose. Local and systemic adverse events occurred in 37.9% and 15.5% of the subjects. No serious adverse event requiring an unscheduled hospital visit occurred. In conclusion, three-doses of Td vaccination to unimmunized adults are safe and effective in inducing protective immunity against diphtheria and tetanus.
Adult ; Aged ; Aged, 80 and over ; Antibodies, Bacterial/blood ; Diphtheria/prevention & control ; Diphtheria-Tetanus Vaccine/*adverse effects/*immunology ; Female ; Humans ; Immunization, Secondary ; Male ; Middle Aged ; Tetanus/prevention & control ; Tetanus Toxoid/immunology

This phase II clinical trial was conducted to compare the immunogenicity and safety of a newly developed tetanus-reduced diphtheria (Td) vaccine (GC1107-T5.0 and GC1107-T7.5) and control vaccine. This study was also performed to select the proper dose of tetanus toxoid in the new Td vaccines. Healthy adolescents aged between 11 and 12 yr participated in this study. A total of 130 subjects (44 GC1107-T5.0, 42 GC1107-T7.5 and 44 control vaccine) completed a single dose of vaccination. Blood samples were collected from the subjects before and 4 weeks after the vaccination. In this study, all subjects (100%) in both GC1107-T5.0 and GC1107-T7.5 groups showed seroprotective antibody levels (> or = 0.1 U/mL) against diphtheria or tetanus toxoids. After the vaccination, the geometric mean titer (GMT) against diphtheria was significantly higher in Group GC1107-T5.0 (6.53) and GC1107-T7.5 (6.11) than in the control group (3.96). The GMT against tetanus was 18.6 in Group GC1107-T5.0, 19.94 in GC1107-T7.5 and 19.01 in the control group after the vaccination. In this study, the rates of local adverse reactions were 67.3% and 59.1% in GC1107-T5.0 and GC1107-7.5, respectively. No significant differences in the number of adverse reactions, prevalence and degree of severity of the solicited and unsolicited adverse reactions were observed among the three groups. Thus, both newly developed Td vaccines appear to be safe and show good immunogenicity. GC1107-T5.0, which contains relatively small amounts of tetanus toxoid, has been selected for a phase III clinical trial.
Antibodies, Bacterial/blood ; Arthralgia/etiology ; Child ; Diphtheria/*prevention & control ; Diphtheria-Tetanus Vaccine/adverse effects/*immunology ; Double-Blind Method ; Female ; Headache/etiology ; Humans ; Male ; Pain/etiology ; Tetanus/*prevention & control ; Treatment Outcome ; Vaccination

BACKGROUND/AIMS: Vaccinations are generally recommended in patients with inflammatory bowel disease (IBD). However, several studies showed low rates of vaccinations in IBD patients. Furthermore, vaccination rate among IBD patients in Korea has never been investigated. We investigated the vaccination rate among IBD patients in Korea and evaluated some factors that might affect the vaccination rate. METHODS: From November 2011 to February 2012, a total of 192 patients with IBD who visited Samsung Medical Center (Seoul, Korea) answered the IRB-approved questionnaire. The questionnaire included their sex, age, residence, past medical history, type of IBD, duration of illness, medications, history of vaccination about measles-mumps-rubella (MMR), varicella, tetanus-diphtheria (Td), influenza, hepatitis A and B, pneumococcus and human papilloma virus (HPV). RESULTS: One hundred twenty one (63.0%) male and 71 (37.0%) female answered the questionnaire. The mean age of the enrolled patients was 39.7 (18-76) years. Eighty four patients (43.8%) had ulcerative colitis and 108 patients (56.3%) had Crohn's disease (CD). The percentage of the patients who had got vaccination was 42.2% for MMR, 34.9% for varicella, 15.6% for Td, 37.5% for influenza, 15.6% for hepatitis A, 52.6% for hepatitis B, 6.3% for pneumococcus and 11.3% for HPV respectively. Not knowing the necessity or the existence were the common reasons for non-vaccination. Age less than 40 years, CD patients and duration of illness less than 10 years were associated with a higher vaccination rate (p=0.002, 0.015 and 0.020, respectively). CONCLUSIONS: Immunization rates for recommended vaccinations were very low in patients with IBD. Efforts to improve vaccination rate are needed.
Adolescent ; Adult ; Aged ; Chickenpox/prevention & control ; Colitis, Ulcerative/pathology ; Crohn Disease/pathology ; Diphtheria/prevention & control ; Female ; Hepatitis A/prevention & control ; Hepatitis B/prevention & control ; Humans ; Inflammatory Bowel Diseases/*immunology/pathology ; Male ; Measles/prevention & control ; Middle Aged ; Mumps/prevention & control ; Papillomavirus Infections/prevention & control ; Pneumococcal Infections/prevention & control ; Questionnaires ; Republic of Korea ; Rubella/prevention & control ; Tetanus/prevention & control ; *Vaccination ; Young Adult

The aim of this study was to investigate the diphtheria-tetanus-pertussis antibody titers after antineoplastic treatment and to suggest an appropriate vaccination approach for pediatric hemato-oncologic patients. A total of 146 children with either malignancy in remission after cessation of therapy or bone marrow failure were recruited. All children had received routine immunization including diphtheria-tetanus-acellular pertussis vaccination before diagnosis of cancer. The serologic immunity to diphtheria, tetanus and pertussis was classified as: completely protective, partially protective, or non-protective. Non-protective serum antibody titer for diphtheria, tetanus and pertussis was detected in 6.2%, 11.6%, and 62.3% of patients, respectively, and partial protective serum antibody titer for diphtheria, tetanus and pertussis was seen in 37%, 28.1%, and 8.9% of patients. There was no significant correlation between the severity of immune defect and age, gender or underlying disease. Revaccination after antineoplastic therapy showed significantly higher levels of antibody for each vaccine antigen. Our data indicates that a large proportion of children lacked protective serum concentrations of antibodies against diphtheria, tetanus, and pertussis. This suggests that reimmunization of these patients is necessary after completion of antineoplastic treatment. Also, prospective studies should be undertaken with the aim of devising a common strategy of revaccination.
Adolescent ; Age Factors ; Antibodies, Bacterial/blood/immunology ; Antineoplastic Agents/therapeutic use ; Child ; Child, Preschool ; Diphtheria/immunology/prevention & control ; Diphtheria-Tetanus-acellular Pertussis Vaccines/*immunology ; Female ; Hematologic Neoplasms/*diagnosis/drug therapy ; Humans ; Immunization, Secondary ; Lymphoma/diagnosis/drug therapy ; Male ; Neuroblastoma/diagnosis/drug therapy ; Sex Factors ; Tetanus/immunology/prevention & control ; Whooping Cough/immunology/prevention & control

INTRODUCTIONChildren in Singapore receive vaccination against hepatitis B virus (HBV) at 0, 1 and 5 or 6 months of age, and vaccination against pertussis, diphtheria, tetanus, and polio at 3, 4 and 5 months of age. Parents often choose to vaccinate with the combined acellular-pertussis-inactivated polio-Hib vaccine (DTPa-IPV/Hib). We investigated whether a combined hexavalent vaccine, DTPa-HBV-IPV/Hib, could replace the separate administration of DTPa-IPV/Hib and HBV for the final vaccination at 5 months of age (Trial DTPa-HBV-IPV-075).

MATERIALS AND METHODSIn an open study, 150 children were randomised to complete their vaccination schedule with DTPa-IPV/Hib + HBV or DTPa-HBV-IPV/Hib.

RESULTSOne month after the final vaccination, there was no difference between groups in seroprotection rates or antibody concentrations against HBV. Seroprotection rates against diphtheria, tetanus, Hib and polio, as well as vaccine response rates to pertussis antigens were also similar between groups. Local and general symptoms occurred at a similar rate after the third dose of either vaccine.

CONCLUSIONThe immunogenicity and reactogenicity of the hexavalent vaccine DTPa-HBV-IPV/Hib (Infanrix hexa, GSK) group is comparable to that of separately administered DTPa-IPV/Hib and HBV vaccines. Combined hexavalent vaccine, DTPa-HBV-IPV/Hib, could replace the separate administration of DTPa-IPV/Hib and HBV for vaccination at 5 months of age, thereby reducing the number of injections required.

Diphtheria ; immunology ; Diphtheria-Tetanus-Pertussis Vaccine ; Female ; Haemophilus Vaccines ; Haemophilus influenzae ; immunology ; Hepatitis B ; prevention & control ; Hepatitis B Antibodies ; blood ; Hepatitis B Vaccines ; administration & dosage ; Humans ; Immunization Schedule ; Infant ; Infant, Newborn ; Male ; Poliovirus Vaccine, Inactivated ; Singapore ; Tetanus ; immunology ; Vaccination ; Vaccines, Combined ; administration & dosage ; Vaccines, Inactivated

HPV vaccination is the most effective way for preventing the cervical cancer. To respond the WHO calling for cervical cancer elimination, some Chinese provincial governments are launching the Free HPV Vaccination Programs for teenagers. Basing on the current stage of domestic utilization and the global immunization strategies of HPV vaccination, this paper provides a comprehensive review of the key aspects in the process of HPV vaccination, including subjects and priority vaccination population, vaccination dose and time interval, the principal of vaccination replacement, and the vaccination suggestion on special populations, etc. The article above contents and gives the advice on the immunization strategy of HPV vaccination in China.
AIDS Vaccines ; Adolescent ; BCG Vaccine ; China ; Diphtheria-Tetanus-Pertussis Vaccine ; Female ; Humans ; Immunization Programs ; Influenza Vaccines ; Measles-Mumps-Rubella Vaccine ; Papillomavirus Infections/prevention & control* ; Papillomavirus Vaccines ; Respiratory Syncytial Virus Vaccines ; SAIDS Vaccines ; Uterine Cervical Neoplasms ; Vaccination

Since a nationwide childhood vaccination with tetanus toxoid, tetanus has become a rare disease in Korea. However, we recently experienced 17 cases of adult tetanus in a university hospital during a 21-month period. Seventy percent of the patients were female, and the mean age was 63 yr (range, 29-87). The majority (88.2%) of the patients did not get primary vaccinations for tetanus and decennial tetanus-diph-theria toxoid booster. Most patients (88.2%), who sustained acute injury, did not seek medical care for their wounds or did not receive the prophylaxis for tetanus. Tetanus was found most frequently among farmers. Tetanus was diagnosed initially only in 53% of patients. The case-fatality ratio was 23.5%. These cases show that recently occurring tetanus in Korea is a disease, affecting the elderly and the female who may have a lower immunity against tetanus, and the farmers who are likely to be exposed to Clostridium tetani. In addition, diagnosis of tetanus is often delayed in area where cases are seen infrequently. Therefore, improved education among patients and physicians, emphasis of anti-tetanus immunization and awareness of tetanus respectively, may be essential for the prevention of disease and the reduction of its mortality.
Adult ; Aged ; Aged, 80 and over ; Agricultural Workers' Diseases/epidemiology ; Diagnostic Errors ; Diphtheria-Tetanus-Pertussis Vaccine ; Emergency Service, Hospital ; Health Education ; Health Knowledge, Attitudes, Practice* ; Human ; Immunization, Secondary/psychology ; Immunization, Secondary/utilization* ; Korea/epidemiology ; Middle Aged ; Tetanus/diagnosis ; Tetanus/epidemiology* ; Tetanus/prevention & control ; Tetanus/therapy ; Tetanus Antitoxin/therapeutic use ; Tetanus Toxoid ; Treatment Outcome ; Vaccination/utilization* ; Wounds, Penetrating/complications

INTRODUCTIONPertussis is a highly communicable, vaccine-preventable respiratory disease and a frequent but often underestimated cause of prolonged cough illness in adults. Protection after childhood vaccination is minimal after 10 years without boosting. The need for adult booster depends on the national epidemiology.

MATERIALS AND METHODSWe did a seroepidemiological survey amongst the adult population (aged 18 to 45 years) of Singapore. None had received pertussis booster vaccine in the preceding 10 years. We measured IgG antibodies to pertussis whole cell antigen.

RESULTSTwo hundred and seventy subjects with the median age of 30 years were enrolled. We found positive IgG antibody levels in 97% of the population. Seropositivity was not associated with age, gender or race.

CONCLUSIONThe seroprevalence in adults was much higher than the previously documented seroprevalence of around 50% in the adolescent age group in Singapore. The increase is most likely due to natural infection with B. pertussis. Pertussis booster vaccine for adolescents/young adults in Singapore would be indicated.

Adolescent ; Adult ; Antibodies, Anti-Idiotypic ; immunology ; Antibodies, Bacterial ; blood ; Bordetella pertussis ; immunology ; Cross-Sectional Studies ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; pharmacology ; Female ; Humans ; Immunoglobulin G ; immunology ; Male ; Middle Aged ; Population Surveillance ; methods ; Prevalence ; Prognosis ; Retrospective Studies ; Seroepidemiologic Studies ; Singapore ; epidemiology ; Whooping Cough ; epidemiology ; immunology ; prevention & control