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Discussion Starter · #1 · (Edited)
I thought this was really interesting!

I clarified below, but I think it is interesting because it helps explain why we don't see many cases of diphtheria or tetanus in adults despite adults being fairly notoriously bad about getting timely 10-year boosters. The article points out that not only has this been seen in other studies, but in the UK, adult boosters are not recommended if a person has had their 5 childhood doses and they have not seen an uptick in tetanus.

http://www.forbes.com/sites/tarahae...-need-another-for-30-more-years/#2d2d6e047b46

The tetanus vaccine prevents the serious infection caused by tetanus bacteria that kills up to one in five people who develop it. Symptoms include muscle stiffness, seizures, fever, headache, stomach or muscle spasms, inability to swallow and a whole body of pain. That’s the bad news.

The good news is, if you had the full series of tetanus vaccine doses as a child or, for those over age 30, any booster in the past several decades, you likely have nothing to worry about. Instead of getting a tetanus booster every 10 years as the Centers for Disease Control and Prevention currently recommends for adults, a new study suggests immunity from the vaccine lasts at least 30 years. That goes for protection against both tetanus and diphtheria, the other disease that the Td booster protects against.

“You want to make sure your child gets the full vaccination series because by doing that, you’re giving protection long into adulthood,” said lead author Mark Slifka, PhD, a professor of molecular biology and immunology at Oregon Health & Science University. “The idea is to go through the full vaccination series and by getting the childhood vaccinations as scheduled, you now have that bonus of having fewer vaccinations as an adult.”


Slifka’s team tested antibody titers—evidence that the body’s immune system can fight off the disease—in 546 adults, and 97% of them had sufficiently high titers to protect them against both tetanus and diphtheria. The researchers calculated the half life of tetanus immunity to be about 14 years and the half life of diphtheria immunity to be about 27 years. That means 14 years after a person’s last booster, they still have more than enough antibodies against tetanus to last them another 14 years—and enough diphtheria antibodies to last them double that time.
 
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Discussion Starter · #2 · (Edited)
Here is the link to the abstract: http://cid.oxfordjournals.org/content/early/2016/03/03/cid.ciw066.short?rss=1

Results. Approximately 97% of the population was seropositive to tetanus and diphtheria as defined by a protective serum antibody titer of ≥0.01 IU/mL. Mean antibody titers were 3.6 and 0.35 IU/mL against tetanus and diphtheria, respectively. Antibody responses to tetanus declined with an estimated half-life of 14 years (95% confidence interval, 11–17 years), whereas antibody responses to diphtheria were more long-lived and declined with an estimated half-life of 27 years (18–51 years). Mathematical models combining antibody magnitude and duration predict that 95% of the population will remain protected against tetanus and diphtheria for ≥30 years without requiring further booster vaccination.
 

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This is pretty cool! I never thought much about vaccines until I became an adult, but now I'm continually in awe of them. Medical science has come a long way and I'm very happy I live in a time/place where I can easily get them for my son.
 

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This would be great, if only the pertussis portion weren't being found to only last a year. Sadly 30 year immunity to tetanus and diphtheria doesn't help much when they're pushing pertussis to more and more frequent boosters but I can't get that without Tdap. I'm curious how so many Tdap vaccines effects a body.


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I'm not concerned about frequency. These vaccines have been tested thoroughly and have been available for quite some time. If my doctor isn't worried, then why should I be? She's spent far more time becoming educated in the medical field than I have.

And the vaccine during pregnancy gives my infant partial immunity until they're old enough to receive the vaccines themselves. I think it's extremely important to follow the guidelines for the safety of my children. Especially since more and more people are becoming unreasonably fearful of vaccines and not getting them.
 

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So I'm a tad confused and unable to access the Forbes article. Did the researchers make sure that the adult study subjects hadn't had any tetanus vaccination since childhood? The continued TDaP doses would muddy the waters, right? Also, for policy and recommendations, the study results are a tad moot because TDaP vaccinations are encouraged at short intervals for pertussis prevention. So even if people don't need as many tetanus shots, they're going to end up with them anyway. :shrug
 

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So I'm a tad confused and unable to access the Forbes article. Did the researchers make sure that the adult study subjects hadn't had any tetanus vaccination since childhood? The continued TDaP doses would muddy the waters, right? Also, for policy and recommendations, the study results are a tad moot because TDaP vaccinations are encouraged at short intervals for pertussis prevention. So even if people don't need as many tetanus shots, they're going to end up with them anyway. :shrug
Unless of course, a monovalent pertussis vaccine is on the way.
In one of her talks, Dr. Humphries said that usually the only time they will admit to issues with a vaccine (or she may have used the word pharmaceuticals) is when something else can take its place.
 

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Unless of course, a monovalent pertussis vaccine is on the way.
In one of her talks, Dr. Humphries said that usually the only time they will admit to issues with a vaccine (or she may have used the word pharmaceuticals) is when something else can take its place.
I agree with Humphries on that, but this is a study that extols the virtues of the tetanus vaccine, just the opposite of fessing up to its shortcomings.

My concern is whether or not the study subjects were adults who hadn't been given a tetanus shot since childhood. Any DTaP/TDaP doses in the past will cloud the results and make it harder to tell if tetanus truly confers vaccine-induced immunity for 30 years. I'm all for a long-lasting vaccine, don't get me wrong. I just want to know more specifics about this study and cannot access Forbes' site due to some fancy-pants adblocker that DH installed. :nerd:
 

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Thanks for sharing. This certainly seems to make the case for separating out the pertussis part for boosters in pregnancy.

The antigens are a tiny part of the shot however, do TDaP or "P" alone would come in similar size vials with similar amounts of ajuvents and preservatives. I doubt there'd be any significantly different safety profile.
 

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Discussion Starter · #12 ·
This would be great, if only the pertussis portion weren't being found to only last a year. Sadly 30-year immunity to tetanus and diphtheria doesn't help much when they're pushing pertussis to more and more frequent boosters but I can't get that without Tdap. I'm curious how so many Tdap vaccines effects a body.


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Sure it helps - for the tetanus and diphtheria portion of the vaccine. A fairly large percentage of adults fall behind on getting the recommended booster every 10 years so the fact that immunity may last at least 30+ years is a good thing. Fewer boosters is always a bonus, do you not agree?
 

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Sure it helps - for the tetanus and diphtheria portion of the vaccine. A fairly large percentage of adults fall behind on getting the recommended booster every 10 years so the fact that immunity may last at least 30+ years is a good thing. Fewer boosters is always a bonus, do you not agree?

I do, if we had a way to do mono pertussis boosters. As it stands now if you want a vaccine for pertussis you have to get the Tdap booster anyway making the longer immunity basically a moot point. That extra Td immunity doesn't change the fact that I could in theory be getting yearly boosters depending on how often I was pregnant if I wanted to opt into the Tdap during pregnancy.


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Discussion Starter · #14 ·
So I'm a tad confused and unable to access the Forbes article. Did the researchers make sure that the adult study subjects hadn't had any tetanus vaccination since childhood? The continued TDaP doses would muddy the waters, right? Also, for policy and recommendations, the study results are a tad moot because TDaP vaccinations are encouraged at short intervals for pertussis prevention. So even if people don't need as many tetanus shots, they're going to end up with them anyway. :shrug
It references this additional study (I haven't read it yet) in the article: http://www.nejm.org/doi/full/10.1056/NEJMoa066092#t=article

These findings matched up with a similar study Slifka led in 2007. In that study, published in the New England Journal of Medicine, the researchers tracked 45 adults for up to 26 years to see how long their tetanus and diphtheria immunity lasted. Titers lasted a similarly long time in that study—a half-life of 19 years for diphtheria antibodies and a half-life of 11 years for tetanus antibodies.

Evidence from other countries also suggests adding time between boosters appears safe. Currently, the World Health Organization only recommends one tetanus-diphtheria booster (Td) given to adults when they first become pregnant (to prevent maternal and infant tetanus) or when they enter military service. The United Kingdom similarly doesn’t recommend any Td boosters for adults as long as they had all five doses of the childhood series. The fact that the UK has not seen an uptick in tetanus cases suggests that people remain protected long after their childhood vaccinations, Slifka said.

Slick and his coauthors suggest that after age 18, when people have received their five initial doses of the tetanus vaccine, they get one booster at age 30 and another at age 60.
The bolded is immediately what I thought of when I read the article. The point that we don't see many cases of tetanus or diptheria in adults despite their booster uptake being fairly low is often brought up on these forums and this study helps explain that. I was also unaware that the UK does not recommend boosters if a person has had their 5 childhood doses - today I learned :)
 

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I agree with Humphries on that, but this is a study that extols the virtues of the tetanus vaccine, just the opposite of fessing up to its shortcomings.

My concern is whether or not the study subjects were adults who hadn't been given a tetanus shot since childhood. Any DTaP/TDaP doses in the past will cloud the results and make it harder to tell if tetanus truly confers vaccine-induced immunity for 30 years. I'm all for a long-lasting vaccine, don't get me wrong. I just want to know more specifics about this study and cannot access Forbes' site due to some fancy-pants adblocker that DH installed. :nerd:
I know I said "issues" but they don't have to necessarily be bad ones. The issue here is that the vaccines (for both tetanus and diphtheria) aren't warranted more than once every 30 years but it is combined with a vaccine that wanes pretty fast- Pertussis. So in the Forbes article they are making the promise that if parents get their children vaccinated with each and every dose and when they are supposed to, they won't need Td for a long time.

But given how rapidly the Tdap’s immunity against pertussis wanes and these new findings, it’s even clearer that a new and better pertussis vaccine is needed, Offit said.
Setting the stage...What's Offit working on these days? :wink:

They don't say whether the participants had been given a tetanus shot since childhood. But the author does flog her book with Emily at the end.
 

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The fact that the UK has not seen an uptick in tetanus cases suggests that people remain protected long after their childhood vaccinations, Slifka said.
The bolded is immediately what I thought of when I read the article. The point that we don't see many cases of tetanus or diptheria in adults despite their booster uptake being fairly low is often brought up on these forums and this study helps explain that. I was also unaware that the UK does not recommend boosters if a person has had their 5 childhood doses - today I learned :)
Believe it or not, I'm not enjoying making these nit-picks because in light of all of the vaccine failures, it's encouraging to learn that one vaccine might have some longevity.

I just don't find the bolded encouraging or compelling by itself. There may be no uptick for tons of reasons, (less exposure to spores with urbanization, immunoglobulin administration to the injured, etc.), so we're back to that cause-correlation issue.

The vaccine may not be routinely given, but health care professionals, military personnel, and travelers may have nonetheless had it. Also, there people with tetanus-vulnerable injuries may receive the immunoglobulin and the vaccine. That said, I sincerely hope that the study subjects were well-vetted, something I won't know until I can access the whole article.
 

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I know I said "issues" but they don't have to necessarily be bad ones. The issue here is that the vaccines (for both tetanus and diphtheria) aren't warranted more than once every 30 years but it is combined with a vaccine that wanes pretty fast- Pertussis. So in the Forbes article they are making the promise that if parents get their children vaccinated with each and every dose and when they are supposed to, they won't need Td for a long time.



Setting the stage...What's Offit working on these days? :wink:

They don't say whether the participants had been given a tetanus shot since childhood. But the author does flog her book with Emily at the end.
I can't find the information that clarifies the claims about not getting since childhood either-anyone find it?

IF a child completes the series we would know this to be the case until they are in their 40's, and thus far we haven't gotten there yet with this generation. Odd???

As to who they tested to know this, clearly a lot are not getting boosters?? All those not taking that "P" part and so many didn't follow up on that 10 year need to re-up?

It does show many must not be sooooo super afraid of tetanus like we are lead to believe!

If anyone finds the number of those not vaccinated for all these years please post it.

By the way I have gone past 30 years without a tetanus of any type and never had the "P" part. No one asked me or tested me!
 

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There is no herd immunity for tetanus.
 
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