ArticlePloS one2016
Long-Term Protection against Diphtheria in the Netherlands after 50 Years of Vaccination: Results from a Seroepidemiological Study.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Waning rate of immunity and duration of protective immunity against diphtheria toxoid as a function of age and number of doses: Systematic review and quantitative data analysis.Human vaccines & immunotherapeutics · 2022Pooled it
- Mapping anti-diphtheria toxin antibody: a systematic review and meta-analysis with multi-level meta-regression.Pathogens and global healthPooled it
- Modeling the transmission dynamics and control strategies during the 2017 diphtheria outbreak in Jakarta, Indonesia.Infectious Disease Modelling · 2026Article
- A literature review and evidence-based evaluation of the Dutch national immunisation schedule yield possibilities for improvements.Vaccine: X · 2024Review
- High-resolution African HLA resource uncovers HLA-DRB1 expression effects underlying vaccine response.Nature medicine · 2024Article
- Surveillance of diphtheria in the Netherlands between 2000-2021: cutaneous diphtheria supersedes the respiratory form.BMC infectious diseases · 2023Article
- High-Throughput IgG Epitope Mapping of Tetanus Neurotoxin: Implications for Immunotherapy and Vaccine Design.Toxins · 2023Article
- Building an integrated serosurveillance platform to inform public health interventions: Insights from an experts' meeting on serum biomarkers.PLoS neglected tropical diseases · 2022Article
- Genetic characterization of diphtheriaIranian journal of microbiology · 2022Article
- Diphtheria in the WHO European Region, 2010 to 2019.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2022Article
- Validation of a diphtheria toxoid multiplex bead assay for serosurveys.Diagnostic microbiology and infectious disease · 2021Article
- Seroprevalence of Measles, Rubella, Tetanus, and Diphtheria Antibodies among Children in Haiti, 2017.The American journal of tropical medicine and hygiene · 2020Article
- Use of tetanus-diphtheria (Td) vaccine in children 4-7 years of age: World Health Organization consultation of experts.Vaccine · 2020Article
- Phenotypic and Genotypic Correlates of Penicillin Susceptibility in Nontoxigenic Corynebacterium diphtheriae, British Columbia, Canada, 2015-2018.Emerging infectious diseases · 2020Article
- Risk of Measles and Diphtheria Introduction and Transmission on Bonaire, Caribbean Netherlands, 2018.The American journal of tropical medicine and hygiene · 2019Article
- Third national biobank for population-based seroprevalence studies in the Netherlands, including the Caribbean Netherlands.BMC infectious diseases · 2019Article
- Transmission of toxigenicEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2018Article
- A model for the regulation of follicular dendritic cells predicts invariant reciprocal-time decay of post-vaccine antibody response.Immunology and cell biology · 2017Article
- Large measles epidemic in the Netherlands, May 2013 to March 2014: changing epidemiology.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2017Article
- Tetanus-diphtheria-acellular pertussis vaccination for adults: an update.Clinical and experimental vaccine research · 2017Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsTo evaluate the National Immunisation Programme (NIP) a population-based cross-sectional seroepidemiological study was performed in the Netherlands. We assessed diphtheria antitoxin levels in the general Dutch population and in low vaccination coverage (LVC) areas where a relatively high proportion of orthodox Protestants live who decline vaccination based on religious grounds. Results were compared with a nationwide seroepidemiological study performed 11 years earlier.
methodsIn 2006/2007 a national serum bank was established. Blood samples were tested for diphtheria antitoxin IgG concentrations using a multiplex immunoassay for 6383 participants from the national sample (NS) and 1518 participants from LVC municipalities. A cut-off above 0.01 international units per ml (IU/ml) was used as minimum protective level.
resultsIn the NS 91% of the population had antibody levels above 0.01 IU/ml compared to 88% in the 1995/1996 serosurvey (p<0.05). On average, 82% (vs. 78% in the 1995/1996 serosurvey, p<0.05) of individuals from the NS born before introduction of diphtheria vaccination in the NIP and 46% (vs. 37% in the 1995/1996 serosurvey, p = 0.11) of orthodox Protestants living in LVC areas had antibody levels above 0.01 IU/ml. Linear regression analysis among fully immunized individuals (six vaccinations) without evidence of revaccination indicated a continuous decline in antibodies in both serosurveys, but geometric mean antibodies remained well above 0.01 IU/ml in all age groups.
conclusionsThe NIP provides long-term protection against diphtheria, although antibody levels decline after vaccination. As a result of natural waning immunity, a substantial proportion of individuals born before introduction of diphtheria vaccination in the NIP lack adequate levels of diphtheria antibodies. Susceptibility due to lack of vaccination is highest among strictly orthodox Protestants. The potential risk of spread of diphtheria within the geographically clustered orthodox Protestant community after introduction in the Netherlands has not disappeared, despite national long-term high vaccination coverage.
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