title: Evaluation of a single dose of diphtheria-tetanus toxoids among adults in Odessa, Ukraine, 1995: immunogenicity and adverse reactions.
abstract: Epidemic diphtheria spread to Ukraine in 1991, where it peaked in 1995 with >5,000 reported cases. To refine epidemic control strategies, immunogenicity of a tetanus-diphtheria toxoids vaccine (Td) containing 2 limits of flocculation (Lf) diphtheria toxoid was evaluated. During a mass vaccination campaign, adults at a clinic in Odessa received one dose of Td. At enrollment, 57.2% of 341 study participants had levels of diphtheria antitoxin (DAT) >/=0.1 IU/mL. Thirty and 180 days after receiving one dose of Td, 91.5% and 84.5% of the participants, respectively, had DAT levels >/=0.1 IU/mL. However, among 40- to 49-year-old participants, only 78.8% and 73.8% had DAT levels >/=0.1 IU/mL at 30 and 180 days, respectively. This study suggests that one dose of 2 Lf diphtheria toxoid is highly effective in raising DAT to protective levels in most adults; however, the study also shows that certain age groups, particularly persons 40-49 and, to a lesser degree, 30-39 years old may require additional doses or a complete three-dose primary vaccination series for optimal protection against diphtheria.
authors.affiliation: Child Vaccine Preventable Disease Branch, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. acg0@cdc.gov
authors.forename: A
authors.initials: A
authors.lastname: Golaz
authors.forename: I R
authors.initials: IR
authors.lastname: Hardy
authors.forename: T G
authors.initials: TG
authors.lastname: Glushkevich
authors.forename: E K
authors.initials: EK
authors.lastname: Areytchiuk
authors.forename: A
authors.initials: A
authors.lastname: Deforest
authors.forename: P
authors.initials: P
authors.lastname: Strebel
authors.forename: M
authors.initials: M
authors.lastname: Wharton
authors.forename: R W
authors.initials: RW
authors.lastname: Sutter
mesh_terms: D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D004165:Diphtheria / Q000276:immunology / Q000517:prevention & control*; D004167:Diphtheria Toxin / Q000097:blood / Q000276:immunology; D004168:Diphtheria Toxoid / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*; D022422:Diphtheria-Tetanus Vaccine; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013745:Tetanus Toxoid / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*; D014455:Ukraine; D014611:Vaccination; D017778:Vaccines, Combined / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D004167:Diphtheria Toxin; D004168:Diphtheria Toxoid; D022422:Diphtheria-Tetanus Vaccine; D013745:Tetanus Toxoid; D017778:Vaccines, Combined