Assessment of Antitoxic Immunity to Diphtheria and Tetanus in the Adult Population

Relevance. Decades of mass immunization against diphtheria and tetanus have led to a decline in the incidence of these infections to sporadic levels. But the risk of infection continues to this day. Aims. To assess the level of antitoxic post-vaccination immunity to diphtheria and tetanus in the adult population, taking into account the vaccination history. Materials and methods. The results of studies of the level of IgG antibodies to diphtheria and tetanus toxoids in the adult population of the Republic of Karelia, examined in 2008 (103 people) and in 2022–2024 (1017 people), were analyzed. Laboratory studies were carried out using the micromethod in the passive hemagglutination reaction. Blood samples were taken without taking into account vaccination history. Persons with an antibody titer of less than 1:20 were considered seronegative. The results of the study of samples from 103 people in 2008 and 400 people in 2022-2024, were compared with data on the receipt of the latest diphtheria and tetanus vaccination. Results. Of 103 people examined in 2008, 2.9 % were seronegative for diphtheria and 3.9 % for tetanus. All seronegative patients were over 50 years of age. 82.5 % of those examined had an antibody titer of ≥ 1:320 to diphtheria and 86.4 % to tetanus. Within 5 years before the study 58.3 % were vaccinated, 6–10 years – 37.9 %, 11–14 years – 3.9 % of those examined. The vast majority of those examined had an antibody titer of ≥ 1:320, regardless of the time elapsed since the last vaccination. 3.9 % of those vaccinated less than 11 years ago were seronegative for diphtheria, and 2.9 % for tetanus. Of 1017 individuals examined in 2022–2024, the proportion of seronegative for diphtheria was 1.2 %, for tetanus – 0.8 %. The frequency of detection of antibodies in titers of 1:320 and higher to diphtheria is 88.0 %, to tetanus – 97.6 %. In persons over 50 years of age, the frequency of lack of protective antibody levels to both infections was slightly lower than in persons 20–49 years of age. Of 400 people, 39.5 % were vaccinated within 5 years before the study, 6–10 years old – 46.8 %, 11–18 years old – 13.8 % of people. Among those reliably vaccinated, 1.0 % were found to be seronegative for diphtheria and none for tetanus. 88.5 % had antibodies in a titer of 1:320 and higher to diphtheria, and 98.3 % to tetanus. More than 90 % of them were individuals with a titer of 1:2560 and 1:5120 to both toxoids. In 85 individuals who did not reliably receive an additional dose of tetanus toxoid after revaccination with ADS-M toxoid, the geometric mean titer of antibodies to tetanus (11.7 log2, 1:3397) was higher than to diphtheria (11.0 log2, 1:2048), but in both cases they were many times higher than the protective level. Conclusions. The study showed a high level of seroprevalence for diphtheria and tetanus in all age groups of the adult population, which confirms the data on high immunization coverage. In the majority of those examined, regardless of the time elapsed since the last vaccination (within 18 years), the antibody titer to both infections exceeded 1:320. The level of antitoxic antibodies to tetanus was slightly higher than to diphtheria.

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