Reactogenicity and immunogenicity of adult versus paediatric diphtheria and tetanus booster dose at 6 years of age

We evaluated the reactogenicity and immunogenicity of a booster dose of diphtheria-tetanus vaccine administered at the age of school-entry, comparing a low-dose vaccine (dT) to the standard paediatric dose (DT). Participants were randomly assigned to receive one of the two vaccines; the study was evaluator-blinded. The frequency of side-reactions was similar when comparing the two groups, except when considering local redness and swelling, which were significantly more frequent among the DT group. The post-booster geometric mean titre of diphtheria antibodies in the DT group was twice as high as that in the dT group (14.1IU/ml versus 7.7IU/ml; P <0.001). The higher antibody response and the comparable reactogenicity indicate that DT should be used as booster at school-entry, particularly if additional booster doses during adolescence or adulthood are not administered.