Diphtheria and Tetanus Immunity Status among Greek Adults: Results from a Nationwide Seroprevalence Study

Diphtheria and tetanus could lead to serious morbidity. We aimed to evaluate immunity levels by measuring specific IgG antibodies for diphtheria and tetanus in serum samples from a nationally expanded sample of the Greek population. A geographically stratified sampling approach based on regional units (NUTS level 2) was applied by considering variables such as age group (30-80+) and sex. In total, 1201 persons (47.7% males and 52.3% females) participated in the survey. Bivariate analysis revealed a negative relationship between diphtheria and tetanus median antibody titers and age. The overall seropositivity rate for diphtheria IgG antibodies (≥0.10 IU/mL) was estimated at 31.5%. Regarding tetanus, the total seropositivity rate was estimated at 59.5% (tetanus IgG antibodies ≥0.10 IU/mL). Logistic regression analysis indicated that age groups <40 years and 40-59 years were independently associated with tetanus seropositivity. Logistic regression also revealed that male sex and being aged 60-69 years were independent risk factors for diphtheria-related seropositivity. Lastly, being resident of some regions was an independent risk factor for both diphtheria- and tetanus-related seropositivity. The present study shows that Greek adults are still not completely immune to diphtheria and tetanus. It is likely possible to achieve optimal immunization coverage by implementing serviceable public health initiatives after comprehending real community needs.

Assessment of Predictors for SARS-CoV-2 Antibodies Decline Rate in Health Care Workers after BNT162b2 Vaccination-Results from a Serological Survey

Background: SARS-CoV-2 is a novel human pathogen causing Coronavirus Disease 2019 that has caused widespread global mortality and morbidity. Since health workers in Israel were among the first to be vaccinated, we had a unique opportunity to investigate the post-vaccination level of IgG anti-S levels antibodies (Abs) and their dynamics by demographic and professional factors. Methods: Prospective Serological Survey during December 2020−August 2021 at Barzilai Medical Center among 458 health care workers (HCW) followed for 6 months after the second BNT162b2 vaccine dose. Results: Antibody levels before the second dose, and 30, 90 and 180 days after were 57.1 ± 29.2, 223 ± 70.2, 172.8 ± 73.3 and 166.4 ± 100.7 AU/mL, respectively. From GEE analysis, females had higher Abs levels (β = 26.37 AU/mL, p = 0.002). Age was negatively associated with Abs, with a 1.17 AU/mL decrease for each additional year (p < 0.001). Direct contact with patients was associated with lower Abs by 25.02 AU/mL (p = 0.009) compared to working with no such contact. The average decline rate overall for the study period was 3.0 ± 2.9 AU/mL per week without differences by demographic parameters and was faster during the first 3 months after vaccination than in the subsequent 3 months. Conclusions: All demographic groups experienced a decline in Abs over time, faster during the first 3 months. Findings of overall Abs lower in males, workers with direct contact with patients, and older workers, should be considered for policy-making about choosing priority populations for additional vaccine doses in hospital settings.

Tetanus in Poland in 2018-2019

BACKGROUND

Tetanus is an acute disease of the nervous system caused by tetanus toxin (neurotoxin) produced by tetanus bacilli (Clostridium tetani). This disease can be prevented by vaccination. In Poland, thanks to obligatory vaccinations of children and adolescents and high vaccination coverage, the disease has been practically eliminated. Less than 20 cases are recorded each year.

AIM

The aim of the work is to analyze the epidemiological indicators of tetanus in Poland in 2018-2019.

METHODS

The analysis of the Polish tetanus epidemiological situation in 2018-2019 was based on a review of data from the bulletins "Infections diseases in Poland in 2018", "Infections diseases in Poland in 2019" and the analysis of the population immunization was made on the basis of data from the bulletins "Protective Vaccination in Poland in 2018", "Protective Vaccination in Poland in 2019".

RESULTS

There are 17 tetanus cases registered in 2019, in 2018 8 cases. The total incidence rate was 0.044 per 100 thousand population and was higher compared to 2018 (0.021). All reports involved hospitalized individuals.

SUMMARY

The few cases of tetanus in Poland occur mainly in people over 60 years of age. These can be linked to the lack of tetanus booster vaccination of adults.