Journal
VACCINE
Volume 38, Issue 9, Pages 2128-2131Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.vaccine.2020.01.040
Keywords
Diphtheria outbreak; Diphtheria toxoid vaccine; Diphtheria; Adult vaccination; Thailand immunization program
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Funding
- Department of Medical Services Research Fund, Thai Ministry of Public Health
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To evaluate seroprotection of different dosing strategies of reduced-diphtheria-tetanus-toxoid vaccine (Td) for adults during a diphtheria outbreak in Thailand, we enrolled 160 healthcare workers and 161 adults aged 20-60 years old and measured diphtheria antitoxin (DAT) level before administration of a Td vaccine. We scheduled a second Td at 4-8 weeks and a third Td at 6-12 months interval. DAT was measured 4 weeks after each dose. DAT levels of >= 0.1 and >= 1 IU/mL were considered as seroprotective and long-term seroprotective. Persons achieving long-term seroprotection were not given a further dose. The baseline seroprotection rate was 32.6%, which increased to 87.1% (95% confidence interval, 83.4-90.8%) after one dose. The seroprotection rate increased slightly with additional doses. The immune response was lowest among persons 30-49 years of age. We suggest 1-dose Td for adults during a diphtheria outbreak, and a 2-dose series being considered for those born before 1980. (C) 2020 Elsevier Ltd. All rights reserved.
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