Dominic J. Balestra, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
Balestra D.; Diphtheria and Tetanus Immunity. Ann Intern Med. 2002;137:774-775. doi: 10.7326/0003-4819-137-9-200211050-00024
Download citation file:
Published: Ann Intern Med. 2002;137(9):774-775.
TO THE EDITOR:
What factors account for the more rapid age-specific decline in immunity to both diphtheria and tetanus, but especially diphtheria, discussed by McQuillan and colleagues (1)? The data suggest that few adult women are given decennial tetanus–diphtheria boosters and that adult men receive either tetanus–diphtheria or tetanus toxoid boosters throughout adulthood, presumably in emergency departments for wound prophylaxis. Alternatively, men receive many tetanus booster shots in young adulthood (for example, during military service), which confer more durable tetanus immunity into middle age than would childhood immunization alone. While the disparity between diphtheria immunity in adult men and women remains relatively stable at about 10% (excluding persons 60 to 69 years of age), the gender gap for immunity to tetanus progressively widens and is worst at advanced ages. McQuillan and colleagues found that both men and women with accessible medical care and a regular physician were less likely to have protective levels of antibody to both toxins; any boosting of immunity probably occurred elsewhere (1).
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only