Diphtheria School Entry Booster
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Diphtheria
A life-threatening disease mainly affecting preschool & school-aged children 1
- Toxin-mediated, potentially systemic disease; transmitted via respiratory droplets or skin lesions1
- Development of pseudo-membrane is a medical emergency1
- 5-10% CFR with highest mortality in young children 2
- 1st epidemiologic stage in countries relying on 3-dose PS only: highest proportion of cases in children 5-14 years (preschool & school-aged children) 1,3
- School attendance = high risk of transmission 3
- Preschool children less able to control respiratory secretions 4
- 2nd epidemiologic stage: shift to adolescents/adults due to recognized waning of immunity after PS1,3
- Regular boosters needed to compensate absence of natural boosting (2nd year, school-entry & school-leaving prior to adolescence)3
References
- WHO. WER, 2017;92(31)
- WHO. Online
- Clarke. SAGE Meeting, April 2017
- Bertilone. Commun Dis Intell Q Rep, 2014;38(3)
Waning Anti-Diphtheria Immunity
A School-entry booster is needed to maintain immunity 1
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Immune responses after a DTaP-IPV/Hib toddler booster (n=69) and before/2 months after DTaP-IPV school-entry booster (n=232) at 5-6 years in children primed w/ DTaP-IPV/Hib at 2-3-4/2-4-6 months (3+1 schedule, France, 2000-01)1
Abbreviations
NA: not available; MO: months; YR: years
Reference
- Mallet. Vaccine, 2004;22(11-12)
Importance of DTaP-IPV School-Entry Booster
Diphtheria
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Diphtheria is a life-threatening disease that still kills young children around the world 1,2
- Vaccine-induced immunity is known to wane after primary vaccination 3
- Introduction of primary vaccination is known to result in 2 epidemiologic stages1,3
- In countries relying on 3-dose primary series only, the highest proportion of cases occurs in children aged 5-14 years (preschool & school-aged children)
- A shift to adolescents/adults as a result of waning immunity after primary vaccination
References
- WHO. WER, 2017;92(31)
- WHO. Online
- Clarke. SAGE Meeting, April 2017
Vaccination Recommendations - WHO
School-entry boosters are recommended for long-lived protection 1-5
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References
- WHO. WER, 2017;92(31)
- WHO. WER, 2017;92(6)
- WHO. WER, 2015;90(351
- WHO. WER, 2016;91(12)
- Martinon-Torres. Expert Rev Vaccines, 2018;17(4)
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