Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-24T15:35:02.098Z Has data issue: false hasContentIssue false

Reactions to tetanus toxoid*

Published online by Cambridge University Press:  15 May 2009

W. G. White
Affiliation:
British Leyland (Austin–Morris) Ltd., Cowley, Oxford
G. M. Barnes
Affiliation:
British Leyland (Austin–Morris) Ltd., Cowley, Oxford
E. Barker
Affiliation:
British Leyland (Austin–Morris) Ltd., Cowley, Oxford
D. Gall
Affiliation:
Wellcome Research Laboratories, Beckenham, Kent
P. Knight
Affiliation:
Wellcome Research Laboratories, Beckenham, Kent
A. H. Griffith
Affiliation:
Wellcome Research Laboratories, Beckenham, Kent
R. M. Morris-Owen
Affiliation:
Radcliffe Infirmary, Oxford
J. W. G. Smith
Affiliation:
Radcliffe Infirmary, Oxford
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

In a factory population the occurrence of reactions to tetanus toxoid was recorded after 6740 injections. The incidence of general reactions was 0·3 % and of local reactions 2·6%. The local reaction rate to the first injection of the basic immunization course was 0·9%, to the second injection 2·7%, and to the third injection 7·4%. To booster injections the rate was 1·6%. The local reaction rate was appreciably higher in women than in men – 14·4 % and 5·7 % respectively in the case of the third injection – and the incidence among women increased with age.

Tetanus vaccine containing 10 Lf of toxoid caused fewer reactions than one containing 20 Lf, but a reduction in the content of aluminium adjuvant did not affect the reaction rate.

Almost all reactors were found to have a satisfactory serum antitoxin concentration at the time of the reaction or developed a satisfactory immunity within 1–6 months.

Skin tests were made in 32 hypersensitive patients. Neither the diluent, thiomersal preservative, nor the culture medium appeared to be responsible for hypersensitivity. The degree of hypersensitivity elicited by a special highly purified toxoid was only very slightly less than that elicited by the commercially pure toxoid. It is suggested that reactions are largely due to the toxoid antigen itself rather than to impurities or other components of the vaccine.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1973

References

REFERENCES

Adams, E. B., Laurence, D. R. & Smith, J. W. G. (1969). Tetanus, p. 64. Oxford and Edinburgh: Blackwell.Google Scholar
Cochran, W. G. (1954). Some methods for strengthening the common X 2tests. Biometrics 10, 417–51.CrossRefGoogle Scholar
Edsall, G., Elliot, M. W., Peebles, T. C., Levine, L. & Eldred, M. C. (1967). Excessive use of tetanus toxoid boosters. Journal of the American Medical Association 202, 1719.CrossRefGoogle ScholarPubMed
Fardon, D. F. (1967). Unusual reactions to tetanus toxoid. Journal of the American Medical Association 199, 125–6.CrossRefGoogle ScholarPubMed
Fisek, N. H., Mueller, J. H. & Miller, P. A. (1954). Muscle extractives in the production of tetanus toxin. Journal of Bacteriology 67, 329–34.CrossRefGoogle ScholarPubMed
Glenny, A. T. & Stevens, M. F. (1938). The laboratory control of tetanus prophylaxis. Journal of the Royal Army Medical Corps 70, 308–10.Google Scholar
Griffith, A. H. (1967). Clinical reactions to tetanus toxoid. In Principles on Tetanus. Proceedings of the International Conference on Tetanus, Bern, 1966 (ed. Eckmann, L.), pp. 299306. Bern: Huber.Google Scholar
Gross, E., Bartels, H., Körner, L. & Kindt, H. (1970). Antitoxintiter nach Tetanus-Immunisiering. Verlauf bei Verwendung von Absorbat- und Fluid-Impfstoffen für die dritte Injektion. Münchener Medizinische Wochenschrift 112, 846–50.Google Scholar
Hansson, H. & Möller, H. (1971 a). Intracutaneous test reactions to tuberculin containing merthiolate as a preservative. Scandinavian Journal of Infectious Diseases 3, 169–72.CrossRefGoogle ScholarPubMed
Hansson, H. & Möller, H. (1971 b). Cutaneous reactions to merthiolate and their relationship to vaccination with tetanus toxoid. Acta allergologica 26, 150–6.CrossRefGoogle ScholarPubMed
McComb, J. A. & Levine, L. (1961). Adult Immunization. II. Dosage reduction as a solution to increasing reactions to tetanus toxoid. New England Journal of Medicine 265, 1152–3.CrossRefGoogle Scholar
Peebles, T. C., Levine, L., Eldred, M. C. & Edsall, G. (1969). Tetanus toxoid emergency boosters: a reappraisal. New England Journal of Medicine 280, 575–81.CrossRefGoogle ScholarPubMed
Reisman, R. E. (1969). Delayed hypersensitivity to merthiolate preservative. Journal of Allergy 43, 245–8.CrossRefGoogle ScholarPubMed
Relihan, M. (1969). Reactions to tetanus toxoid. Journal of the Irish Medical Association 62, 430–4.Google ScholarPubMed
Rubbo, S. D. (1966). New approaches to tetanus prophylaxis. Lancet ii, 450–3.Google Scholar
Scheibel, I., Bentzon, M. W., Christensen, P. E. & Biering, A. (1966). Duration of immunity to diphtheria and tetanus after active immunization. Acta pathologica et microbiologica scandinavica 67, 380–92.CrossRefGoogle ScholarPubMed
Snell, E. S. & Burland, W. L. (1970). Intramuscular site for adjuvant vaccines. Medical Officer 23, 36.Google Scholar
Trinca, J. C. (1963). Active tetanus immunisation: effect of a reduced reinforcing dose of adsorbed toxoid on the partly immunised reactive patient. Medical Journal of Australia ii, 389–92.CrossRefGoogle Scholar
White, W. G. & Ungar, J. (1967). Practical aspects of tetanus prophylaxis in a factory population. In Principles on Tetanus. Proceedings of the International Conference on Tetanus, Bern, 1966 (ed. Eckmann, L.), pp. 401–8. Bern: Huber.Google Scholar
White, W. G., Barnes, G. M., Griffith, A. H., Gall, D., Barker, E. & Smith, J. W. G. (1969). Duration of immunity after active immunisation against tetanus. Lancet ii, 95–6.CrossRefGoogle Scholar
Whittingham, H. E. (1940). Anaphylaxis following administration of tetanus toxoid. British Medical Journal i, 292–3.CrossRefGoogle Scholar
Yeager, L. B. (1967). Problems of immunising college-age adults. Archives of Environmental Health 15, 502–7.CrossRefGoogle ScholarPubMed