Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Incidence of Tetanus and Diphtheria in Relation to Adult Vaccination Schedules.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 42 citations in OpenAlex.
- Trial
- Prevention and treatment of tetanus in China: a comparative review against international standards.Infection · 2026Review
- Clinical characteristics, management, and outcomes of severe tetanus in the intensive care unit.BMC infectious diseases · 2026Observational
- Planning for the future of the American Society for Microbiology's Health Unit by the Council on Microbial Sciences.mSphere · 2026Review
- The Role and Safety of Aluminum Adjuvants in Childhood Vaccines.Pediatrics · 2026Review
- Tetanus Control in the United States and Global Disaster Settings: Public Health Disparities and Prevention Strategies.Medicina (Kaunas, Lithuania) · 2026Review
- Lessons learned from successful implementation of tetanus and diphtheria vaccination programs.Clinical microbiology reviews · 2025Review
- Factors Influencing the Length of Emergency Intensive Care Unit Stay in Adult Tetanus Patients.International journal of general medicine · 2025Article
- Understanding the impact of adult pertussis and current approaches to vaccination: A narrative review and expert panel recommendations.Human vaccines & immunotherapeutics · 2024Review
- Article
- Serologic Immunity to Tetanus in the United States, National Health and Nutrition Examination Survey, 2015-2016.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- COVID-19 vaccine boosters for young adults: a risk benefit assessment and ethical analysis of mandate policies at universities.Journal of medical ethics · 2024Article
- Herd immunity, vaccination and moral obligation.Journal of medical ethics · 2023Article
- Antitetanus toxoid antibodies in mothers and neonates: a single-centre study from Uganda.BMJ paediatrics open · 2023Article
- COVID-19 booster uptake among US adults: Assessing the impact of vaccine attributes, incentives, and context in a choice-based experiment.Social science & medicine (1982) · 2022Article
- Active Circulation of Corynebacterium ulcerans among Nonhuman Primates.Microbiology spectrum · 2022Article
- Tdap Booster Vaccination for Adults: Real-World Adherence to Current Recommendations in Italy and Evaluation of Two Alternative Strategies.International journal of environmental research and public health · 2022Article
- Cardiac arrest associated with non-toxigenicFrontiers in medicine · 2022Article
- Antibody persistence 2 and 3 years after booster vaccination of adolescents with recombinant acellular pertussis monovalent aPEClinicalMedicine · 2021Article
- Reply to Plotkin.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe World Health Organization (WHO) does not recommend routine adult booster vaccination for tetanus and diphtheria after completion of the childhood vaccination series. However, many countries continue to implement adult booster vaccinations, leading to the question of whether this is necessary to reduce the incidence of these 2 rare diseases.
methodsWe conducted an observational cohort study based on WHO case reports from 2001 through 2016. We compared the incidence of tetanus and diphtheria in 31 North American and European countries that either do or do not recommend adult booster vaccination.
resultsCountries that vaccinate adults every 5-20 years (group 1) were compared with countries that do not routinely vaccinate adults for tetanus or diphtheria (group 2). Comparison of group 1 vs group 2 revealed no significant decline in tetanus incidence rates among countries that vaccinate adults (P = .52; risk ratio [RR] = 0.78; 95% confidence interval [CI], .36 to 1.70). The risk of contracting diphtheria was increased among countries that vaccinate adults due to inclusion of Latvia, a country that had poor vaccination coverage (P < .001). However, if Latvia is excluded, there is no difference in diphtheria incidence between countries that do or do not routinely vaccinate adults (P = .26; RR = 2.46; 95% CI, .54 to 11.23).
conclusionsReview of >11 billion person-years of incidence data revealed no benefit associated with performing adult booster vaccinations against tetanus or diphtheria. Similar to other vaccines, this analysis supports the WHO position on adult booster vaccination and, if approved by governing health authorities, this may allow more countries to focus healthcare resources on vulnerable and undervaccinated populations.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.