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BioMed Research International
Volume 2014, Article ID 541319, 10 pages
Review Article

Booster Vaccination: The Role of Reduced Antigen Content Vaccines as a Preschool Booster

1Department of Prevention, O.U. Hygiene and Public Health, LHU 4 “Chiavarese”-Liguria Region, Corso Dante 163, Chiavari, 16043 Genoa, Italy
2Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genoa, Italy
3Department of Prevention, LHU Taranto, Viale Virgilio 31, 74100 Taranto, Italy
4Department of Prevention, LHU 20 Verona, Via Salvo d’Acquisto 7, 37122 Verona, Italy

Received 30 April 2013; Revised 25 September 2013; Accepted 21 October 2013; Published 11 February 2014

Academic Editor: Gerardo Chowell

Copyright © 2014 Giovanni Gabutti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The need for boosters for tetanus, diphtheria, pertussis, and polio, starting from preschool age, is related to the waning immune protection conferred by vaccination, the elimination/reduction of natural boosters due to large-scale immunization programs, and the possibility of reintroduction of wild agents from endemic areas. Taking into account the relevance of safety/tolerability in the compliance with vaccination among the population, it have been assessed whether today enough scientific evidences are available to support the use of dTap-IPV booster in preschool age. The review of the literature was conducted using the PubMed search engine. A total of 41 works has been selected; besides, the documentation produced by the World Health Organization, the European Centre for Disease Control, and the Italian Ministry of Health has been consulted. Many recent papers confirm the opportunity to use a low antigenic dose vaccine starting from 4 to 6 years of age. There is also evidence that 10 years after immunization the rate of seroprotected subjects against diphtheria does not differ significantly between those vaccinated with paediatric dose (DTaP) or reduced dose (dTaP or dTap) product. The dTpa vaccine is highly immunogenic for diphtheria toxoids regardless of prior vaccination history (2 + 1 and 3 + 1 schedules).