Objective: To evaluate immunogenicity and reactogenicity of primary vaccination with reduced-antigen-content diphtheria-tetanus-acellular pertussis (dTpa) or dTpa-inactivated poliovirus (dTpa-IPV) vaccine compared to diphtheria-tetanus-toxoid vaccines (Td) in adults ≥ 40 years of age without diphtheria or tetanus vaccination for 20 years or with an unknown vaccination history. Research design and methods: Double-blind, randomized, controlled clinical trial. Primary vaccination with either three doses of dTpa, one dose of dTpa-IPV followed by two doses of Td, or three doses of Td vaccine (control) administered in a 0-1 -6-month schedule. Main outcome measures: Blood samples were collected before commencement and 1 month after each dose. Local and general symptoms were solicited for 15 days after each dose. Results: A total of 460 adults were enrolled, of whom over 48% did not have protective antibody concentrations against diphtheria and tetanus. One month after dose 3 > 99% had seroprotective anti-diphtheria and tetanus antibodies. Three doses were required to maximize anti-diphtheria seroprotection rates. A vaccine response to pertussis antigens was observed in > 92% of dTpa and dTpa-IPV recipients after dose 1. One month after dTpa-IPV, > 98.4% had seroprotective anti-polio titres. No statistically significant differences in local or general symptoms between groups were observed. Conclusions: dTpa and dTpa-IPV can provide primary vaccination of adults. Combinations of dTpa or dTpa-IPV can be used to replace Td and provide booster vaccination against pertussis and polio simultaneously with diphtheria and tetanus, even in situations where the primary vaccination history is unknown.

Adult, Diphtheria, Pertussis, Poliovirus, Primary vaccination, Tetanus
dx.doi.org/10.1185/03007X233034, hdl.handle.net/1765/35999
Current Medical Research and Opinion
Erasmus MC: University Medical Center Rotterdam

Theeten, H, Rümke, H, Hoppener, F.J.P, Vilatimó, R, Narejos, S, van Damme, P, & Hoet, B. (2007). Primary vaccination of adults with reduced antigen-content diphtheria-tetanus-acellular pertussis or dTpa-inactivated poliovirus vaccines compared to diphtheria-tetanus-toxoid vaccines. Current Medical Research and Opinion, 23(11), 2729–2739. doi:10.1185/03007X233034