Journal article
Single doses of diphtheria-tetanus-pertussis and poliomyelitis vaccines are sufficient to generate a booster-type response to tetanus in most migrant children.
- Fougère Y Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland. Electronic address: yves.fougere@chuv.ch.
- El Houss S Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland.
- Suris JC Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland.
- Rouvenaz-Defago S Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland.
- Miletto D Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland.
- Von der Weid L Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland.
- Willen F Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland.
- Williams-Smith JA Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland.
- Gehri M Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Switzerland.
- Crisinel PA Unit of Pediatric Infectious Diseases and Vaccinology, Department Women-Mother-Child, Lausanne University Hospital, Switzerland.
- 2019-09-17
Published in:
- Vaccine. - 2019
Migrant children
Tetanus
Vaccination catch-up
Adolescent
Antibodies, Bacterial
Antibody Formation
Child
Child, Preschool
Diphtheria
Diphtheria-Tetanus-Pertussis Vaccine
Drug Administration Schedule
Europe
Female
Humans
Infant
Male
Poliomyelitis
Poliovirus Vaccine, Oral
Prospective Studies
Serologic Tests
Switzerland
Tertiary Care Centers
Tetanus
Tetanus Toxoid
Transients and Migrants
Vaccination Coverage
Whooping Cough
English
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.
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.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.vaccine.2019.08.089
- PMID 31522805
- Persistent URL
- https://sonar.ch/global/documents/55478
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