Ah, maybe because there is no anti-lightning vaccine
Oregon Health & Science University
The safety and savings depend on maintaining strong
childhood vaccination rates, researchers emphasized.
"By maintaining high childhood vaccination coverage, we
not only protect kids, but we may actually be able to reduce adult booster
vaccinations," said lead author Mark Slifka, Ph.D., professor of
microbiology and immunology in the OHSU School of Medicine and the Oregon
National Primate Research Center. "That would save $1 billion a year in
the U.S. while maintaining the safety and protection of the general
population."
EDITOR'S NOTE: Though I don't doubt the study's calculations, they apply only "by maintaining high childhood vaccination coverage." But thanks to vaccine skepticism, childhood vaccination rates are dropping to the detriment of all. - Will Collette
Slifka noted that dropping the 10-year schedule for adult
boosters would more closely match guidelines recommended by the World Health
Organization.
The review bolsters previous OHSU research in 2016 and in
2020 that concluded the combined vaccine produced at least 30 years of
immunity, well beyond the current recommendation of every 10 years for adults
from the U.S. Centers for Disease Control and Prevention. The vaccine is
usually given as a combined tetanus, diphtheria and pertussis vaccine, known as
DTaP.
In the U.S., childhood vaccinations are recommended six
times, from infancy through age 12.
The new review suggests doing away with adult boosters
altogether, as long as childhood vaccination rates remain high and the vaccine
remains available on a case-by-case basis. For example, it may be necessary for
someone injured in a workplace accident or car crash to receive a tetanus
booster.
A natural experiment in the U.K. and France
Published recently in the journal Clinical
Microbiology Reviews, the review highlights a comparison between two
industrialized countries just 21 miles across the English Channel: France and
the United Kingdom. Both countries have excellent childhood vaccination
coverage, similar to the U.S.
"This represents sort of an experiment of nature,"
Slifka said. "We have one country with over 60 million people that for
decades has continued to vaccinate adults throughout their lifetime and another
nearby country that also has over 60 million people, but over the past 50
years, they have never recommended adult booster vaccinations.
"The question we asked is, 'What happens if we don't
vaccinate the adults? Are there more cases of disease or are these people
protected after completing their childhood vaccination series?'"
Similar to the United States, France has a recommended
booster vaccination schedule for adults. In contrast, except during pregnancy
or for wound management, the United Kingdom hasn't recommended boosters for
tetanus and diphtheria beyond age 14 since the 1950s.
Yet, despite decades of adult booster vaccination, the
review found that France had virtually no advantage over the U.K. in the rates
of tetanus or diphtheria. In fact, the review found that the UK had a slightly
lower rate overall.
In addition, "herd immunity" held strong even in
2022 when the U.K. reported an outbreak of 73 imported diphtheria cases among
immigrants seeking asylum. This spike in cases was almost equal to the total
number of diphtheria cases reported in the entire country over the previous 20
years combined.
"Remarkably, despite this proportionally large influx
of imported diphtheria cases, there was no evidence of transmission reported
among other asylum seekers who arrived by other routes or among staff or health
care workers," the authors write.
The U.K. Health Security Agency concluded that the country's
current childhood-focused vaccination program is sufficient for preventing the
spread of diphtheria and that the risk to the general UK population remains
low.
Strong rates of childhood vaccination are critical
The findings highlight the remarkable durability of
protection following childhood vaccination against a pair of diseases that were
once all but a death sentence.
In 1948, the U.S. mortality rate for tetanus was 91%. Before
the introduction of antibiotics and vaccines, the mortality rate for diphtheria
was roughly 50%. To this day, diphtheria kills roughly one out of 10 people who
aren't vaccinated against it.
Today, the public health threat is diminished thanks to
childhood vaccinations as well as booster shots recommended in pregnancy.
"Thanks to childhood vaccinations, these diseases are incredibly rare," Slifka said. "In fact, you're 10 to 1,000 times more likely to be struck by lightning than to be diagnosed with tetanus and diphtheria in the United States."
Research reported in this publication was supported by the Office of the Director of the National Institutes of Health, award number P51OD011092. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
