O. Simonsen et al., FALL-OFF IN IMMUNITY FOLLOWING DIPHTHERIA REVACCINATION - AN 8 YEAR FOLLOW-UP-STUDY, APMIS. Acta pathologica, microbiologica et immunologica Scandinavica, 104(12), 1996, pp. 921-925
Diphtheria may occur even among previously vaccinated persons and know
ledge of the duration of immunity is of crucial importance when design
ing effective vaccination programmes. In a follow-up study of 42 repre
sentative probands revaccinated 8 years previously, a continuous fall-
off in antitoxic immunity was demonstrated. 98% were still protected (
antitoxin concentration >0.01 IU/ml). From the distribution of titres
in the group the individual risk of susceptibility 8 years after revac
cination was calculated to be 0.8 parts per thousand (0.2-2.9 parts pe
r thousand, 95% confidence limits). Thus, repeated revaccinations are
required to secure continuous protection. The fall-off pattern for dip
htheria antitoxin was approximately the same as for tetanus antitoxin.
Peak values following revaccination are decisive for the duration of
immunity. As peak values following vaccination depend on naturally acq
uired immunity and consequently decrease as indigenous diphtheria in a
population disappears, highly potent vaccines are required to secure
long-term immunity following diphtheria revaccination. The effects of
dose and adjuvant are discussed.