Effect of a diphtheria booster vaccination in adults with a documented history of an incomplete primary series vaccination.
BACKGROUND
An incomplete series of diphtheria vaccination is frequently found in the vaccination documents of adult patients. This paper investigates the effect of a booster vaccination in adults with an incomplete series of primary vaccination.


METHODS
The effect of one diphtheria booster vaccination in adults with a documented history of only two childhood vaccinations has been investigated in 21 adults. Before the vaccination and 4 to 8 weeks thereafter, blood samples were taken and analyzed with an in vitro neutralization assay.


RESULTS
None of the participants had prevaccinal full protective diphtheria antitoxin levels (AT) > or = 0.1 IU/ml and four (19%) had limited serological protection (AT 0.01 to 0.1 IU/ml). After the vaccination, 14 individuals (67%) had protective LeveLs and six (29%) had limited protective levels. The risk for post-booster non-protection (AT < 0.1 IU/ml) was 7.7 times higher in comparison with a group of 170 adults with a history of at least one booster vaccination.


CONCLUSIONS
A specific immunologic memory exists in adults with a history of only two previous diphtheria vaccinations. However, our results also indicate the need for a second booster vaccination in this group if long-term protection is to be achieved.
Hasselhorn
H M
HM
Dept. of Occupational Medicine, University of Wuppertal, Wuppertal, Germany. hasselho@uni-wuppertal.de
Hofmann
F
F
Nübling
M
M
D000328:Adult; D004166:Diphtheria Antitoxin / Q000097:blood / Q000276:immunology; D004168:Diphtheria Toxoid / Q000008:administration & dosage* / Q000276:immunology*; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007117:Immunization, Secondary; D007156:Immunologic Memory / Q000276:immunology; D008297:Male; D008875:Middle Aged
D004166:Diphtheria Antitoxin; D004168:Diphtheria Toxoid