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The early symptoms of the disease are lockjaw (the most recognizable of its physical effects), stiffness, and problems swallowing. This bacterium produces two exotoxins, one of which (tetanospasmin) is a neurotoxin that causes the symptoms of tetanus. Find me on Twitter here.Tetanus is a disease of the nervous system caused by bacteria called Clostridium tetani. My book, The Informed Parent, with co-author Emily Willingham, is available for pre-order. But given how rapidly the Tdap’s immunity against pertussis wanes and these new findings, it’s even clearer that a new and better pertussis vaccine is needed, Offit said.
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The mother’s antibodies get transferred to the fetus and offer their newborn their best chance of avoiding whooping cough. “The goal is to prevent death from pertussis, and the best way to prevent death from pertussis is to vaccinate pregnant women in the third trimester,” Offit said. Hence the recommendation that pregnant women get Tdap boosters in every pregnancy. While tetanus and diphtheria immunity appear to last much longer than scientists realized, the pertussis vaccine’s immunity doesn’t last nearly as long (or work as effectively) as everyone had hoped, contributing to outbreaks. My suggestion here would be to make sure the study is reproduced, and then one could reasonably consider giving the vaccines at longer intervals between doses.”īut there is one hitch in all this-the tetanus-diphtheria vaccine also can include the pertussis, or whooping cough vaccine, in a combination called Tdap, and there is no stand-alone pertussis vaccine. “As always, the vaccine schedule should always be subject to review. “My impression is that this study is well done and deserves attention, and I think it would be important for those findings to be reproduced,” said Paul Offit, MD, chief of the division of infectious diseases atĬhildren' s Hospital of Philadelphia. This the first study to show such long half-lives for tetanus and diphtheria titers among a large group of adults at one point in time.
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Each time ACIP meets, they review an extensive collection of evidence to determine whether any changes should be recommended among vaccines. (Currently, approximately 1.6 anaphylactic reactions occur per 1 million doses of the vaccine, and 5 to 10 cases of brachial plexus neuropathy occur per 1 million doses.) Uncommon but very painful Arthus reactions-an extremely painful inflammation that can occur when the immune system goes into overdrive after a tetanus vaccination-would also become even less common than they already are.īut that doesn’t mean the CDC’s Advisory Committee on Immunization Practices is going to make any rapid changes to the schedule. Considering the 16 million doses of tetanus administered each year, lengthening the time between booster shots for adults could eliminate up to 25 cases of severe allergic reactions and anywhere from 80 to 160 cases of a rare nerve disorder called brachial plexus neuropathy. “What our data indicates is that you want to get your shots at age 30 and age 60 so your immune system still responds well to your immunity and immunity will last into your older years when it’s harder to boost that immune response.”Īside from a lot fewer sore arms, doing away with two thirds of the annual tetanus vaccines given also reduces the far rarer but more serious side effects that can result from the vaccine. The immune system becomes far less effective as people age, which explains why flu and shingles vaccines do not work as effectively or last as long for older adults. “The older you are, the harder it is to vaccinate you,” Slifka points out. Slick and his coauthors suggest that after age 18, when people have received their five initial doses of the tetanus vaccine, they get one booster at age 30 and another at age 60. The fact that the UK has not seen an uptick in tetanus cases suggests that people remain protected long after their childhood vaccinations, Slifka said.
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The United Kingdom similarly doesn’t recommend any Td boosters for adults as long as they had all five doses of the childhood series. Currently, the World Health Organization only recommends one tetanus-diphtheria booster (Td) given to adults when they first become pregnant (to prevent maternal and infant tetanus) or when they enter military service. Evidence from other countries also suggests adding time between boosters appears safe.