TY - JOUR
T1 - Protection against Tetanus and Diphtheria in Europe
T2 - The impact of age, gender and country of origin based on data from the MARK-AGE Study
AU - Weinberger, Birgit
AU - Keller, Michael
AU - Putzer, Christina
AU - Breitenberger, Daniel
AU - Koller, Bernhard
AU - Fiegl, Simone
AU - Moreno-Villanueva, María
AU - Bernhardt, Jürgen
AU - Franceschi, Claudio
AU - Voutetakis, Konstantinos
AU - Gonos, Efstathios S.
AU - Hurme, Mikko
AU - Sikora, Ewa
AU - Toussaint, Olivier
AU - Debacq-Chainiaux, Florence
AU - Grune, Tilman
AU - Breusing, Nicolle
AU - Bürkle, Alexander
AU - Grubeck-Loebenstein, Beatrix
N1 - Funding Information:
We thank all participants at the various recruitment centers and the European Commission for financial support through the FP7 large-scale integrating project “European Study to Establish Biomarkers of Human Ageing” (MARK-AGE; grant agreement no.: 200880 ).
Publisher Copyright:
© 2017 Elsevier Inc.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Due to the successful implementation of vaccination strategies early-life morbidity and mortality due to infectious disease has been reduced dramatically. Vaccines against tetanus and diphtheria are among the most frequently used vaccines worldwide, but various studies in different European countries have shown that protection against tetanus and particularly against diphtheria is unsatisfactory in adults and older persons. In this study we analyzed tetanus- and diphtheria-specific antibody concentrations in 2100 adults of different age from 6 selected European countries (Austria, Belgium, Germany, Greece, Italy, Poland) in order to investigate differences in the level of protection against tetanus and diphtheria across Europe. Our data reveal that tetanus- and diphtheria-specific antibody concentrations vary greatly between countries, which is also reflected in the percentage of persons with antibody concentrations below the protective level (0.1 IU/ml), which ranged from 2 to 31% percent for tetanus and 28–63% for diphtheria. In most countries, tetanus- and diphtheria-specific antibody concentrations decrease with age. This phenomenon is more pronounced in countries with generally low antibody levels, such as Italy, Poland and Greece. Interestingly, tetanus-specific antibody concentrations are generally higher in males than in females, which is probably due to vaccination during their military service or more frequent booster vaccinations after injuries, whereas no gender-related differences were found for diphtheria-specific antibodies. In conclusion, our study demonstrates that the European population is not fully protected against tetanus and diphtheria. Measures to improve protection should include a life-long perspective on vaccination, more education to increase awareness of and compliance with vaccination guidelines, and a harmonization of recommendations and incentives across Europe.
AB - Due to the successful implementation of vaccination strategies early-life morbidity and mortality due to infectious disease has been reduced dramatically. Vaccines against tetanus and diphtheria are among the most frequently used vaccines worldwide, but various studies in different European countries have shown that protection against tetanus and particularly against diphtheria is unsatisfactory in adults and older persons. In this study we analyzed tetanus- and diphtheria-specific antibody concentrations in 2100 adults of different age from 6 selected European countries (Austria, Belgium, Germany, Greece, Italy, Poland) in order to investigate differences in the level of protection against tetanus and diphtheria across Europe. Our data reveal that tetanus- and diphtheria-specific antibody concentrations vary greatly between countries, which is also reflected in the percentage of persons with antibody concentrations below the protective level (0.1 IU/ml), which ranged from 2 to 31% percent for tetanus and 28–63% for diphtheria. In most countries, tetanus- and diphtheria-specific antibody concentrations decrease with age. This phenomenon is more pronounced in countries with generally low antibody levels, such as Italy, Poland and Greece. Interestingly, tetanus-specific antibody concentrations are generally higher in males than in females, which is probably due to vaccination during their military service or more frequent booster vaccinations after injuries, whereas no gender-related differences were found for diphtheria-specific antibodies. In conclusion, our study demonstrates that the European population is not fully protected against tetanus and diphtheria. Measures to improve protection should include a life-long perspective on vaccination, more education to increase awareness of and compliance with vaccination guidelines, and a harmonization of recommendations and incentives across Europe.
KW - Antibody concentrations
KW - Diphtheria
KW - Europe
KW - Tetanus
KW - Vaccination
UR - http://www.scopus.com/inward/record.url?scp=85031326449&partnerID=8YFLogxK
U2 - 10.1016/j.exger.2017.08.037
DO - 10.1016/j.exger.2017.08.037
M3 - Article
AN - SCOPUS:85031326449
SN - 0531-5565
VL - 105
SP - 109
EP - 112
JO - Experimental Gerontology
JF - Experimental Gerontology
ER -
