Serologic Immunity to Tetanus in the United States, National Health and Nutrition Examination Survey, 2015–2016

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Bampoe, Valerie D. ; Brown, Nicole ; Deng, Li ; Schiffer, Jarad ; Jia, Lily Tao ; Epperson, Monica ; Gorantla, Yamini ; Park, So Hee ; Ao, Jingning ; Acosta, Anna M. ; Hariri, Susan
• 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.
  
  
• Subjects:
  Adult Aged Antibodies, Bacterial Child Humans Immunization, Secondary Nutrition Surveys Tetanus Tetanus Toxoid United States Vaccination

  More +
• Keywords:
  ELISA Microsphere-based Multiplex Antibody Capture Assay MMACA National Health And Nutrition And Examination Survey NHANES Sero-immunity
• Source:
  Clin Infect Dis. 78(2):470-475
• Pubmed ID:
  37787062
• Pubmed Central ID:
  PMC10922579
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; CC/CDC HHSUnited States/
• Volume:
  78
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:cea9845fdf5d2860c72df59a18c18a79e5053186b26af9a9bf6ecbf2350abb3c6bc988350b1d1d9f6073bbd4b155c10ec1244d1f638c8665e670973bea5adccd
• Download URL:
  https://stacks.cdc.gov/view/cdc/151633/cdc_151633_DS1.pdf
• File Type:
  [PDF - 204.39 KB ]