Serologic Immunity to Tetanus in the United States, National Health and Nutrition Examination Survey, 2015–2016
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2 17 2024
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Source: Clin Infect Dis. 78(2):470-475
Details:
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Alternative Title:Clin Infect Dis
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Personal Author:
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Description:Background:
Tetanus, a life-threatening infection, has become rare in the United States since introduction of tetanus toxoid-containing vaccines (TTCVs), recommended as a childhood series followed by decennial boosters beginning at age 11–12 years; vaccination uptake is high in children but suboptimal in adults. The objective of this study was to estimate the prevalence of sero-immunity to tetanus among persons aged ≥6 years in the United States and to identify factors associated with tetanus sero-immunity. Understanding population protection against tetanus informs current and future vaccine recommendations.
Methods:
Anti-tetanus toxoid antibody concentrations were measured for participants of the 2015–2016 National Health and Nutrition Examination Survey (NHANES) aged ≥6 years for whom surplus serum samples were available using a microsphere-based multiplex antibody capture assay. Prevalence of sero-immunity, defined as ≥0.10 IU/mL, was estimated overall and by demographic characteristics. Factors associated with tetanus sero-immunity were examined using multivariable regression.
Results:
Overall, 93.8% of the U.S. population aged ≥6 years had sero-protection against tetanus. Prevalence of sero-immunity was above 90% across racial/ethnic categories, sex, and poverty levels. By age, ≥90% had protective sero-immunity through age 69 years but prevalence of sero-immunity declined thereafter, with 75.8% of those aged ≥80 years having protective sero-immunity. Older age (adjusted prevalence ratio (aPR): 0.89, 95% CI: 0.85–0.92) and being born outside the United States (aPR: 0.96, 95% CI: 0.93–0.98) were significantly associated with lower prevalence of sero-immunity.
Conclusion:
The majority of the U.S. population has vaccine-induced sero-immunity to tetanus, demonstrating the success of the vaccination program.
Primary Funding Source:
Centers for Disease Control and Prevention.
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Pubmed ID:37787062
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Pubmed Central ID:PMC10922579
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Funding:
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Volume:78
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Issue:2
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Supporting Files:No Additional Files