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Home Eurosurveillance Weekly Release  2003: Volume 7/ Issue 35 Article 4
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Eurosurveillance, Volume 7, Issue 35, 28 August 2003
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Citation style for this article: Andersen P, Stellfeld M. Danish childhood vaccination programme modified to include pertussis and polio boosters at 5 years of age. Euro Surveill. 2003;7(35):pii=2284. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2284

Danish childhood vaccination programme modified to include pertussis and polio boosters at 5 years of age

Peter Andersen (PEA@ssi.dk), Department of Epidemiology, and Michael Stellfeld, Medical Department, Statens Serum Institut, Denmark

Pertussis has re-emerged in many western countries in recent years, even in countries that have had high coverage vaccination programmes for many years (1). Vaccine induced immunity to pertussis wanes, leaving older children, adolescents, and adults susceptible to infection. Several countries in Europe have implemented pertussis boosters in their national immunization programmes (see 'vaccine schedules', 'pertussis', at http://www.euvac.net)

In Denmark, from 1 September 2003, the recommended vaccination at 5 years of age will include revaccination against pertussis (2). A trivalent DTP booster against diphtheria, tetanus, and pertussis will be used. The DTP booster contains the same amount of diphtheria and tetanus vaccines as the DT booster (currently recommended at 5 years of age) that it replaces, and half as much acellular whooping cough vaccine as the contents of DTaP-IPV/ActHib used for primary immunization. The DTP booster cannot be used for primary vaccination.

Whooping cough is endemic in Denmark, with epidemics occurring every 3-5 years. The disease is particularly serious in infants, but also causes morbidity in older children and young people, in whom the cause may remain unidentified. The child is well protected by primary vaccination for some years, after which time the protection fades. Older children who have received primary vaccination therefore risk getting whooping cough at a later stage and constitute an infection reservoir for younger, unprotected children. Increasing evidence indicates that adults may also form an important reservoir and that parents may infect their own infants (3). After revaccination with DTP booster, protection against diphtheria and tetanus lasts at least 10 years (4). The duration of protection against pertussis is unknown for the vaccines and schedule in use in Denmark, but may be around 10 years as well.

From 1 July 2004, the recommended vaccination at 5 years will be further modified to include revaccination against polio (5). The first cohort of children not to have received OPV will reach the age of 5 years at this time.

References:
  1. Crowcroft NS, Britto J. Whooping cough - a continuing problem. BMJ 2002; 324: 1537-8. (http://bmj.com/cgi/reprint/324/7353/1537.pdf) [accessed 28 August 2003]
  2. Anderson P, Stellfeld M. Childhood vaccination programme modified. EPI-NEWS 2003; (26-33): 13 August. (http://www.ssi.dk/sw4195.asp) [accessed 28 August 2003]
  3. Crowcroft NS, Booy R, Harrison T, Spicer L, Britto J, Mok Q, et al. Severe and unrecognised: pertussis in UK infants. Arch Dis Child 2003; 88: 802-6. (abstract available at http://adc.bmjjournals.com/cgi/content/abstract/archdischild;88/9/802?etoc) [accessed 28 August 2003]
  4. Christiansen AH, Rønne T. Td revaccination and immunity. EPI-NEWS 2000; (49): 6 December. (http://www.ssi.dk/sw2977.asp) [accessed 28 August 2003]
  5. Andersen P. OPV cessation at the end of August 2003. EPI-NEWS 2003; (24): 11 June. (http://www.ssi.dk/sw4030.asp) [accessed 28 August 2003]

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