Tetanus immunity as a surrogate for past diphtheria-tetanus-pertussis immunization in migrant children.

BACKGROUND

Data on vaccination coverage in recently arrived refugee children are essential to formulate catch-up recommendations. "Overimmunizing" is costly and associated with risks of hyperimmunization, whereas assuming up-to-date immunizations may be misleading.

METHODS

We retrospectively collected data from 92 migrant children referred to our hospital between January 2009 and May 2010.

RESULTS

According to our guidelines, 68 (73.9%) children without evidence of up-to-date immunizations received a booster dose of an age-appropriate tetanus-containing vaccine. As a surrogate for diphtheria-tetanus-pertussis-poliomyelitis immunity, tetanus antibodies were measured by enzyme-linked immunosorbent assay 1 month later in 55 of 68 (80.8%) children 6 months to 16 years of age (median, 7 years) from 23 countries. All but 2 children (3.6%) had reached high antibody titers (>1.0 IU/mL) and required no further booster. Unnecessary additional tetanus immunizations thus were avoided in 53 of 55 (96.4%) patients.

CONCLUSION

Assessing antitetanus antibody responses in migrant children allows individual vaccination schedules and avoids the risks of hyperimmunization.