Investigation of the baseline tetanus antibody level and its persistence in a military unit

Vaccine. 2021 Jul 13;39(31):4328-4334. doi: 10.1016/j.vaccine.2021.06.026. Epub 2021 Jun 16.

Abstract

Objectives: To determine tetanus antibody levels in army recruits and evaluate the persistence of immunity following tetanus booster immunization in adults.

Methods: A total of 680 recruits were selected for observation of their tetanus antibody levels. From 2005 to 2015, 691 peacekeepers with tetanus vaccination were included in the questionnaire-based and serological survey based on cluster stratification. The tetanus antibody-positive rate, geometric mean concentration (GMC), and their respective changes over time were analyzed in different age groups, regions, and years after tetanus booster immunization.

Results: The positivity rates of tetanus antibodies in the recruits and peacekeepers were 74.85% and 99.86%, respectively (χ2 = 193.00, P < 0.05) and the antibody GMCs were 0.05 and 0.70 IU/mL (t = 15.73, P < 0.05). The antibody positivity rates of recruits from 12 provinces ranged from 47.62% (Hubei) to 100% (Inner Mongolia) (χ2 = 37.24, P < 0.05) and the antibody GMCs ranged from 0.02 (Hubei) to 0.09 IU/mL (Heilongjiang) (F = 5.19, P < 0.01). Among the 691 peacekeepers, no statistically significant difference in antibody positivity rate was detected between men and women. After administration of one booster dose of the tetanus vaccine, a protective antibody level was calculated to persist up to 22 years; a significant difference in antibody levels was observed within 10 years between one and two or more booster doses.

Conclusion: The rate at which recruits tested positive for tetanus antibodies was low. Thus, it is necessary to screen for tetanus antibodies during military recruitment and implement a precision-based booster immunization protocol for tetanus vaccine. Moreover, one dose of the tetanus vaccine booster has been calculated to maintain a protective antibody level up to 22 years, without the need for repeated reinforcements during this period.

Keywords: Adult; Antibody level; Immune persistence; Peacekeeper; Recruit; Tetanus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Bacterial
  • China
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Female
  • Humans
  • Immunization, Secondary
  • Male
  • Military Personnel*
  • Tetanus Toxoid
  • Tetanus* / prevention & control

Substances

  • Antibodies, Bacterial
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Tetanus Toxoid