title: Tetanus immunity as a surrogate for past diphtheria-tetanus-pertussis immunization in migrant children.
abstract: BACKGROUND
  Data on vaccination coverage in recently arrived refugee children are essential to formulate catch-up recommendations. "Overimmunizing" is costly and associated with risks of hyperimmunization, whereas assuming up-to-date immunizations may be misleading.
  
  
  METHODS
  We retrospectively collected data from 92 migrant children referred to our hospital between January 2009 and May 2010.
  
  
  RESULTS
  According to our guidelines, 68 (73.9%) children without evidence of up-to-date immunizations received a booster dose of an age-appropriate tetanus-containing vaccine. As a surrogate for diphtheria-tetanus-pertussis-poliomyelitis immunity, tetanus antibodies were measured by enzyme-linked immunosorbent assay 1 month later in 55 of 68 (80.8%) children 6 months to 16 years of age (median, 7 years) from 23 countries. All but 2 children (3.6%) had reached high antibody titers (>1.0 IU/mL) and required no further booster. Unnecessary additional tetanus immunizations thus were avoided in 53 of 55 (96.4%) patients.
  
  
  CONCLUSIONS
  Assessing antitetanus antibody responses in migrant children allows individual vaccination schedules and avoids the risks of hyperimmunization.
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, University Hospitals of Geneva and University of Geneva Medical School, Geneva, Switzerland.
authors.forename: Isabel Garcia
authors.initials: IG
authors.lastname: de la Fuente
authors.forename: Noémie
authors.initials: N
authors.lastname: Wagner
authors.forename: Claire-Anne
authors.initials: CA
authors.lastname: Siegrist
authors.forename: Klara M
authors.initials: KM
authors.lastname: Posfay-Barbe
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood*; D000992:Antitoxins / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013745:Tetanus Toxoid / Q000008:administration & dosage* / Q000276:immunology; D014171:Transients and Migrants
chemical_list: D000907:Antibodies, Bacterial; D000992:Antitoxins; D015415:Biomarkers; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D013745:Tetanus Toxoid