RSS Feeds
Serologic Immunity to Diphtheria and Tetanus in the United States
- Geraldine M. McQuillan, PhD;
- Deanna Kruszon-Moran, MS;
- Adamadia Deforest, PhD;
- Susan Y. Chu, PhD, MSPH; and
- Melinda Wharton, MD, MPH
- From the National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland; St. Christopher's Hospital for Children, Philadelphia, Pennsylvania; and the National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
Background: Serologic data on diseases that are preventable by vaccine are useful to evaluate the success of immunization programs and to identify susceptible subgroups.
Objective: To provide national estimates of immunity to diphtheria and tetanus by measurement of serum antibody levels.
Design: Examination of data from the Third National Health and Nutrition Examination Survey, a representative cross-sectional sample of the U.S. population.
Setting: 89 randomly selected locations throughout the United States.
Participants: 18 045 persons 6 years of age or older who were examined from 1988 to 1994.
Measurements: Serum samples obtained at a single time point were tested for diphtheria and tetanus antitoxin.
Results: Overall, 60.5% of Americans 6 years of age or older had fully protective levels of diphtheria antibody (≥ 0.10 IU/mL) and 72.3% had protective levels of tetanus antibody (>0.15 IU/mL). Ninety-one percent of Americans 6 to 11 years of age had protective levels of both diphtheria and tetanus antibody; this proportion decreased to approximately 30% among persons 70 years of age (29.5% for diphtheria and 31.0% for tetanus). Adult Mexican-Americans were slightly less likely to have protective levels of antibody to both toxins. Only 47% of persons 20 years of age or older had levels that were protective against both diseases, and only 63% of adults who were protected against tetanus were also protected against diphtheria.
Conclusions: A substantial proportion of adults in the United States do not have antibody levels that are protective against diphtheria and tetanus. In addition, although the recommended vaccine is a combination of tetanus and diphtheria, only 63% of adults with protective antibody to tetanus also had protective antibody to diphtheria.
Article and Author Information
-
Acknowledgment: The authors thank Ms. Alicia Spadaccino, MT (ASCP), for providing the diphtheria test results.
-
Requests for Single Reprints: Geraldine M. McQuillan, PhD, Division of Health Examination Statistics, National Center for Health Statistics, 6525 Belcrest Road, Room 1000, Hyattsville, MD 20782; e-mail, gmm2{at}cdc.gov.
-
Current Author Addresses: Dr. McQuillan and Ms. Kruszon-Moran: Division of Health Examination Statistics, National Center for Health Statistics, 6525 Belcrest Road, Room 1000, Hyattsville, MD 20782.
-
Dr. Deforest: Department of Pathology and Laboratory Medicine, St. Christopher's Hospital for Children, Erie Avenue at Front Street, Philadelphia, PA 19134-1095.
-
Drs. Chu and Wharton: National Immunization Program, Centers for Disease Control and Prevention, Corporate Square Facility, Building 12, Corporate Square Boulevard, Atlanta, GA 30329.
-
Author Contributions: Conception and design: G.M. McQuillan, D. Kruszon-Moran, M. Wharton.
-
Analysis and interpretation of the data: G.M. McQuillan, D. Kruszon-Moran, S.Y. Chu, M. Wharton.
-
Drafting of the article: G.M. McQuillan, D. Kruszon-Moran, A. Deforest, S.Y. Chu.
-
Critical revision of the article for important intellectual content: G.M. McQuillan, D. Kruszon-Moran, A. Deforest, S.Y. Chu, M. Wharton.
-
Final approval of the article: G.M. McQuillan, D. Kruszon-Moran, A. Deforest, S.Y. Chu, M. Wharton.
-
Provision of study materials or patients: G.M. McQuillan.
-
Statistical expertise: G.M. McQuillan, D. Kruszon-Moran.
-
Administrative, technical, or logistic support: A. Deforest.
-
Collection and assembly of data: G.M. McQuillan.
- Copyright ©2004 by the American College of Physicians
Related Clinical Content
