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Medscape
6 days ago
- Health
- Medscape
Tetanus Shots: Lifesavers or Overkill?
A review in the Clinical Microbiology Reviews highlighted the remarkable success of vaccines in nearly eliminating tetanus and diphtheria. Today, widespread immunization has made these diseases so rare that a person is up to 1000 times more likely to be struck by lightning than to develop either infection. In the US, tetanus occurs at a rate of less than one case per 10 million person-years, whereas diphtheria is even rarer, at approximately one case per billion person-years. In recent decades, nearly all deaths from these diseases have occurred in individuals who have not completed the primary vaccination series. The authors pointed out that the exceptionally rare deaths from tetanus or diphtheria 'are not due to vaccine failure and instead are mainly due to a failure to vaccinate.' Booster Debate Tetanus and diphtheria vaccines are unusual because many countries, including the US and Italy, recommend routine boosters in adults every 10 years — a policy not applied to any other childhood vaccine. However, the authors argued that these boosters were not necessary to maintain population-level immunity. They presented serologic, epidemiologic, and historical data showing that adult booster doses could be safely avoided with substantial cost savings. Mark K. Slifka, PhD, professor at Oregon Health & Science University (OHSU), Portland, Oregon, and senior scientist at the OHSU's Oregon National Primate Research Center, based in Hillsboro, Oregon, and colleagues emphasized that adult booster doses, which have already been phased out in several European countries, can be safely discontinued if high vaccination coverage in children is maintained and vaccines remain available for specific clinical needs. UK vs France A striking comparison between the UK and France supports the argument that adult booster vaccinations may be unnecessary. Both countries have similar population sizes and comparable pediatric vaccination schedules for tetanus and diphtheria, with five doses each compared with four in Italy, with coverage rates between 94% and 96%. The UK had never implemented routine boosters for adults, whereas France required boosters every 10 years until 2012. Since 2014, France has recommended boosters every 10 years for adults older than 65 years and every 20 years for younger adults at ages 25, 45, and 65 years. Despite these differing booster policies, disease incidence remains extremely low in both countries, with fewer than one tetanus case per 4 million person-years (0.21 vs 0.12 cases per million person-years in the UK and France, respectively) and fewer than one diphtheria case per 16 million person-years (0.06 vs 0.03 per million person-years in the UK and France, respectively). Notably, the incidence was slightly lower in the UK, where boosters were not administered to adults. A study of 30 high-income countries found no significant difference in tetanus or diphtheria rates between countries that administered boosters to both children and adults and those that administered boosters only to children. Eight countries did not offer adult tetanus boosters, and nine did not offer adult diphtheria boosters. Cost Savings The authors estimated that eliminating routine 10-yearly tetanus-diphtheria boosters in the US, in alignment with the World Health Organization (WHO) guidance, which has not recommended adult boosters since 2017, could save approximately $1 billion annually. In Europe, eight countries besides the UK do not schedule routine tetanus and diphtheria boosters: Spain (which stopped boosters in 2009 but offers a single dose around the age of 65 years), Croatia (one booster after the age of 60 years), Ireland, Iceland, Malta, the Netherlands, Poland, and Hungary. The WHO continues to recommend a tetanus and diphtheria booster during each pregnancy, administered as the diphtheria-tetanus-pertussis vaccine to protect newborns from whooping cough, as well as for travelers to diphtheria-endemic areas and for wound management in potential tetanus cases. Vaccination is also advised for individuals who are unvaccinated or whose immunization status is uncertain. Long-Term Immunity Why should routine booster shots be stopped for adults? This is because the antibodies last longer. Studies have shown that tetanus antibodies have a half-life of 11 years, whereas diphtheria antibodies have a half-life of 19 years. In a study of over 500 adults in the US, 99% of those younger than 60 years and 97% overall had protective tetanus antibody levels; comparable results were found for diphtheria. Other studies have shown no significant decrease in antibody levels with age, even in the absence of booster doses. The researchers emphasized that the goal of an immunization program is to prevent disease and not just to produce antibodies. Unlike tetanus, diphtheria is contagious; however, herd immunity remains strong in the absence of adult booster shots. In 2022, the UK reported 73 cases of diphtheria among asylum-seeking immigrants, the same number as that reported over the previous 20 years. None of the healthcare workers were infected. UK health officials concluded that the existing vaccination coverage was sufficient to prevent the spread of diphtheria and that the risk to the general population remained low.
Yahoo
15-05-2025
- Health
- Yahoo
Animal advocates want proposed Oregon bill amended to close OHSU primate center
PORTLAND, Ore. () — Animal advocates have taken a public hearing on a proposed bill as an opportunity to urge lawmakers to shut down the Oregon National Primate Research Center. The House Committee On Emergency Management, General Government, and Veterans held the hearing on on Tuesday. Although the measure would ban research facilities from using public funds to cover 'medically unnecessary' testing on dogs and cats, several people provided testimony on why the proposal should also call for the closure of Oregon Health & Science University's monkey research lab. Downtown Vancouver street parking could no longer be free on weekends. Here's why The facility first opened after accepting its first group of rhesus macaques in the 1960s. Since then, OHSU has reported that the primates help boost patient care by teaching researchers more about vaccines and cures for diseases like Parkinson's, measles and mumps. But in recent years, activists with groups like the Physicians Committee for Responsible Medicine and have accused the university of abusing the monkeys by keeping them confined in tight areas and neglecting to treat them when they're sick. 'One of the facts that's irrefutable about the primate center is that it has violated the federal Animal Welfare Act repeatedly year after year,' Lake Oswego resident Amy Meyer, who testified on behalf of PETA, said at SB 181's hearing. 'They cannot get it right and every violation cited by the U.S. Department of Agriculture means horrific suffering and often a terrible death has happened to the monkeys caged there.' Amid the renewed push to close the primate center, its ability to care for the animals and the importance of the research. In a statement issued last month, the university emphasized that its work is heavily regulated by federal officials and there are veterinary specialists that address the monkeys' medical and dental needs. The institution has also asserted it only uses animals for research that doesn't offer an alternative option. OHA: 'Alarming' rise in syphilis during pregnancy contribute to infant health issues 'We are working toward the goal of ultimately eliminating the need for animals, and specifically nonhuman primates, to conduct research,' OHSU said. 'Despite great advances in new approach methodology, the technology to eliminate animal research isn't there yet.' Following Tuesday's hearing, the House committee has scheduled another work session for SB 181. It is slated for Tuesday, May 20. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
02-05-2025
- Health
- Yahoo
OHSU takes public stance against calls to close primate research center
PORTLAND, Ore. () — Oregon Health and Science University has publicly sounded off against the push for the institution to close its monkey research facility. On Wednesday, the university published an announcement addressing animal advocates' claims on why the Oregon National Primate Research Center should be shut down. 'Usually somebody blabs': Tony White's 2005 death still unsolved People for the Ethical Treatment of Animals, better known as PETA, asked the National Institutes for Health's Office of Laboratory Animal Welfare to investigate the OHSU center in mid-April. The organization's revealed a 4-year-old monkey died a 'painful death' from sepsis last year after people at the Beaverton facility ignored her symptoms. The Physicians Committee for Responsible Medicine has also slammed the research center, referring to it as a the university could replace by further investing in patient care. In response, OHSU said the claim 'compares apples to oranges.' The institution noted the facility is mostly funded by federal grants that only cover specific research efforts, which improve patient care by identifying new ways to treat diseases. The university also pushed back on animal advocates' argument that the research is cruel and unnecessary. 'While scientific advancements have introduced alternative non-animal models, this technology cannot fully replicate the complexity of a living system at this time,' OHSU . 'Nonhuman primate research remains critical for studying conditions such as Alzheimer's, Parkinson's, infectious diseases and reproductive health — areas where animal-free methods cannot yet provide complete answers.' May Day rally in Salem defends immigrant workers' rights, opposes sanctuary city cuts The institution noted that animal research is heavily regulated by federal authorities. OHSU also claimed its primates grow up with their social groups and form bonds with researchers in the facility. Many of the university's points were shared in the rally that researchers held on the west campus last month, after Oregon Gov. Tina Kotek urged leaders to close the primate facility. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
