Use of tetanus-diphtheria (Td) vaccine in children 4–7 years of age: World Health Organization consultation of experts. Issue 21 (6th May 2020)

• Record Type: Journal Article
• Authors: Desai, Shalini; Scobie, Heather M.; Cherian, Thomas; Goodman, Tracey
• Is Part Of: Vaccine. Volume 38:Issue 21(2020)
• Page Start: 3800
• Page End: 3807
• Publication Date: 2020-05-06
• Subjects: Diphtheria -- Tetanus -- Vaccine -- Boosters -- Childhood -- Life-course; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2020.01.018
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Low-dose tetanus-diphtheria (Td) vaccine is currently not licensed for children age 4–7 years. Evidence suggests using Td as a second booster in ages 4–7 years yields durable immunity. Evidence supports the recommendation to use Td booster dose in ages 4–7 years. Abstract: For lifetime protection against diphtheria and tetanus, the World Health Organization (WHO) recommends six doses of diphtheria and tetanus containing vaccines. Td (reduced diphtheria toxoid, ≥2–5 IU) vaccines are currently licensed for ages 7 years and older, but use of Td vaccine for ages 4 years and older would have advantages for immunization programs in many low- and middle-income countries. For this reason, WHO convened an expert consultation to review the currently available evidence for the use of Td vaccine from 4 to 7 years of age which concluded: (1) no relevant biological difference in immune response in the relevant age group compared with children over 7 years of age; (2) adequate seroprotection in several studies with Td vaccine in the 4–7 age group and many studies using combination vaccines; (3) durable and protective response of at least 9–11 years duration in several longitudinal and modelling studies, (4) less reactogenicity compared with use of full-dose diphtheria vaccine, potentially improving the vaccination experience; and (5) adequate control of diphtheria in several countries using Td-containing combination vaccines in 4–7 year old children. On this basis, the experts concluded that from a programmatic perspective, Td vaccine given in ages 4–7 years, as a second booster dose in a six-dose series, would provide adequate protection against diphtheria and tetanus and recommended steps to include this change in age extension listed in the package insert.