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Sechsfachimpfung, Tetanus [2]
p11 Karin
Ich bin auf folgende Studie gestoßen:
Immunogenicity of combined diphtheria, tetanus, and pertussis vaccine given at 2, 3, and 4 months versus 3, 5, and 9 months of age.
Booy R, Aitken SJ, Taylor S, Tudor-Williams G, Macfarlane JA, Moxon ER, Ashworth LA, Mayon-White RT, Griffiths H, Chapel HM.
Department of Paediatrics, John Radcliffe Hospital, Oxford, UK.
In the UK an accelerated schedule for immunisation against diphtheria, tetanus, and pertussis (injections at 2, 3, and 4 months of age) was introduced in 1990 to replace the more widely spaced schedule of 3, 5, and 9 months. There is concern, however, that the new schedule may be less immunogenic and therefore less protective than the old schedule. We have measured serum concentrations of antibodies against diphtheria, pertussis, and tetanus in infants immunised according to the two regimens. Both schedules resulted in protective concentrations of antibody against tetanus and diphtheria and in satisfactory antibody responses to three pertussis antigens (filamentous haemagglutinin, pertussis toxin, fimbriae). However, immunisation by the old schedule led to significantly higher antibody concentrations against both diphtheria and tetanus than did immunisation by the new schedule (p less than 0.01). In infants immunised with the new schedule, postimmunisation antibody concentrations against tetanus toxoid and against two pertussis antigens (pertussis toxin and fimbriae) were significantly lower in infants in whom preimmunisation (maternally derived) antibody concentrations were high (p less than 0.02). The findings suggest that with an accelerated immunisation schedule maternal antibodies can have an inhibitory effect on the responses to immunisation against tetanus and pertussis.
Gibt’s jetzt bei Keuchhusten Nestschutz oder nicht?
Häufig wird von Impfgegner als Argument gegen die Pertussisimpfung angeführt, dass die besonders gefährdeten Neugeborenen ohnehin noch nicht von der Impfung profitieren würden (abgesehen davon, dass sie dann wenigstens kein Erwachsener mit Pertussis anhustet.)
Könnte man früher impfen?
Ist der Schluss richtig, dass durch das neue Impfschemata die Rate der lokalen Impfreaktion verringert wird, entsprechend Ihren Ausführungen bzgl. Antikörpertiter – „Bei hohen Tetanus (und Diphtherie) AK kommt es bei erneutem (häufigen) Impfen zu einer komplexbildung Tet-Ag -Tetanus AK was zu einer Complementaktivierung und zu einem schmerzhaft geschwollenem Arm führen kann.“
Immunogenicity of combined diphtheria, tetanus, and pertussis vaccine given at 2, 3, and 4 months versus 3, 5, and 9 months of age.
Booy R, Aitken SJ, Taylor S, Tudor-Williams G, Macfarlane JA, Moxon ER, Ashworth LA, Mayon-White RT, Griffiths H, Chapel HM.
Department of Paediatrics, John Radcliffe Hospital, Oxford, UK.
In the UK an accelerated schedule for immunisation against diphtheria, tetanus, and pertussis (injections at 2, 3, and 4 months of age) was introduced in 1990 to replace the more widely spaced schedule of 3, 5, and 9 months. There is concern, however, that the new schedule may be less immunogenic and therefore less protective than the old schedule. We have measured serum concentrations of antibodies against diphtheria, pertussis, and tetanus in infants immunised according to the two regimens. Both schedules resulted in protective concentrations of antibody against tetanus and diphtheria and in satisfactory antibody responses to three pertussis antigens (filamentous haemagglutinin, pertussis toxin, fimbriae). However, immunisation by the old schedule led to significantly higher antibody concentrations against both diphtheria and tetanus than did immunisation by the new schedule (p less than 0.01). In infants immunised with the new schedule, postimmunisation antibody concentrations against tetanus toxoid and against two pertussis antigens (pertussis toxin and fimbriae) were significantly lower in infants in whom preimmunisation (maternally derived) antibody concentrations were high (p less than 0.02). The findings suggest that with an accelerated immunisation schedule maternal antibodies can have an inhibitory effect on the responses to immunisation against tetanus and pertussis.
Gibt’s jetzt bei Keuchhusten Nestschutz oder nicht?
Häufig wird von Impfgegner als Argument gegen die Pertussisimpfung angeführt, dass die besonders gefährdeten Neugeborenen ohnehin noch nicht von der Impfung profitieren würden (abgesehen davon, dass sie dann wenigstens kein Erwachsener mit Pertussis anhustet.)
Könnte man früher impfen?
Ist der Schluss richtig, dass durch das neue Impfschemata die Rate der lokalen Impfreaktion verringert wird, entsprechend Ihren Ausführungen bzgl. Antikörpertiter – „Bei hohen Tetanus (und Diphtherie) AK kommt es bei erneutem (häufigen) Impfen zu einer komplexbildung Tet-Ag -Tetanus AK was zu einer Complementaktivierung und zu einem schmerzhaft geschwollenem Arm führen kann.“
15.05.2009 16:23