{"id":2229,"date":"2025-11-19T16:23:48","date_gmt":"2025-11-19T14:23:48","guid":{"rendered":"https:\/\/resemedicin.se\/svarigar\/?p=2229"},"modified":"2025-11-19T16:24:03","modified_gmt":"2025-11-19T14:24:03","slug":"2025-11-19-dt-eller-dt-vid-grundimmunisering-av-vuxen","status":"publish","type":"post","link":"https:\/\/resemedicin.se\/svarigar\/2025-11-19-dt-eller-dt-vid-grundimmunisering-av-vuxen\/","title":{"rendered":"2025-11-19 dT eller DT vid grundimmunisering av vuxen?"},"content":{"rendered":"\n<p><strong>Fr\u00e5ga:<\/strong> Funderade kring er rekommendation f\u00f6r grund-vaccination av ovaccinerad vuxen (<a href=\"https:\/\/resemedicin.se\/svarigar\/2025-05-27-vaccination-till-helt-ovaccinerad-vuxen\/\">https:\/\/resemedicin.se\/svarigar\/2025-05-27-vaccination-till-helt-ovaccinerad-vuxen\/<\/a>). Hur kommer det sig att ni rekommenderar Boostrix polio (booster-vaccin) ist\u00e4llet Tetravac (fulldos-vaccin)? T\u00e4nker mig att de l\u00e4gre antigen-doserna i booster-vaccinet potentiellt skulle ge s\u00e4mre immunsvar?<\/p>\n\n\n\n<p><strong>Svar:<\/strong> \u00c4ven om boostervaccinet inneh\u00e5ller en betydligt l\u00e4gre niv\u00e5 av difteriantigen (2 vs 20 IU) rekommenderar WHO och flertalet internationell auktoriteter att grundimmunisera vuxna med ett dT-inneh\u00e5llande boostervaccin vilket enligt studier och god internationell erfarenhet ger fullgod immunitet med l\u00e4gre risk f\u00f6r biverkningar.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.who.int\/teams\/immunization-vaccines-and-biologicals\/policies\/the-immunological-basis-for-immunization-series\" target=\"_blank\" rel=\"noreferrer noopener\">WHO The Immunological basis for immunization series &#8211; Diphtheria<\/a>: \u201d<em>An effective course of primary adult immunization<\/em>\u00a0<em>should include three doses of adult formulation toxoid (reduced potency) with an<\/em>\u00a0<em>interval of four to six weeks between the first and second dose and 6 to 12 months<\/em>\u00a0<em>between the second and third dose.<\/em><\/li>\n\n\n\n<li><a href=\"https:\/\/assets.publishing.service.gov.uk\/media\/683d87d481deb72cce2680a4\/Diphtheria-green_book-chapter-15-30-05-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">UK Green Book<\/a>: \u201d\u00a0<em>Vaccines containing the higher dose of diphtheria toxoid (D) are used to achieve satisfactory primary immunisation of children under ten years of age. Vaccines containing the lower dose of diphtheria toxoid (d) should be used for primary immunisation in individuals aged ten years or over, where they provide a satisfactory immune response, and the risk of reactions is minimised.<\/em>\u201d<\/li>\n\n\n\n<li><a href=\"https:\/\/www.cdc.gov\/pinkbook\/hcp\/table-of-contents\/chapter-7-diphtheria.html\" target=\"_blank\" rel=\"noreferrer noopener\">CDC Pink book<\/a>: \u201d<em>Persons age 7 years or older should receive the Td vaccine or Tdap vaccine, even if they have not completed a series of DTaP or DT<\/em>\u201d<\/li>\n\n\n\n<li><a href=\"https:\/\/thl.fi\/sv\/teman\/infektionssjukdomar-och-vaccinationer\/vaccin-a-o\/kombinationsvaccin-mot-stelkramp-difteri-kikhosta-polio-och-hib\/vaccin-mot-difteri-och-stelkramp-dt-for-vuxna\" target=\"_blank\" rel=\"noreferrer noopener\">Finska THL<\/a>: \u201d<em>dT-vaccinet kan ocks\u00e5 ges som grundvaccin till barn som fyllt 14\u00a0\u00e5r och \u00e4ldre<\/em>.\u201d<\/li>\n<\/ul>\n\n\n\n<p><a href=\"https:\/\/www.folkhalsomyndigheten.se\/smittskydd-beredskap\/vaccinationer\/rekommendationer-for-vaccination\/rekommendationer-om-grundvaccination-av-vuxna-mot-difteri-och-stelkramp\/\">Folkh\u00e4lsomyndigheten<\/a> har efter en\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36333877\/\">litteraturgenomg\u00e5ng<\/a>\u00a0anslutit sig till denna internationella standard:  \u201d<em>Folkh\u00e4lsomyndigheten rekommenderar att anv\u00e4nda difteri- och stelkrampsvaccin med reducerad antigenhalt (dT-vaccin) f\u00f6r grundvaccination av vuxna.<\/em>\u201d<\/p>\n\n\n\n<p>Dock finns divergerande \u00e5sikter h\u00e4r. M\u00e5nga svenska infektionsl\u00e4kare \u00e4r tveksamma till grundimmunisering av vuxna med boostervaccin:<\/p>\n\n\n\n<p>Se <a href=\"https:\/\/resemedicin.se\/svarigar\/2025-07-14-grundimmunisering-mot-difteri-stelkramp-for-vuxna-tillagg\/\">svarskommentar<\/a> till det citerade Svar ig\u00e5r-inl\u00e4gget. Fulldos rekommenderas ocks\u00e5 i \u00a0<a href=\"https:\/\/vardgivarguiden.se\/kunskapsstod\/smittskydd\/amnesomraden\/vaccination\/grundskydd-for-vuxna\">V\u00e5rdgivarguiden<\/a> fr\u00e5n Smittskydd Stockholm.<\/p>\n\n\n\n<p>Jag sj\u00e4lv har vacklat i fr\u00e5gan, men nu valt att ansluta mig till WHO-rekommendationen.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Fr\u00e5ga: Funderade kring er rekommendation f\u00f6r grund-vaccination av ovaccinerad vuxen (https:\/\/resemedicin.se\/svarigar\/2025-05-27-vaccination-till-helt-ovaccinerad-vuxen\/). Hur kommer det sig att ni rekommenderar Boostrix polio (booster-vaccin) ist\u00e4llet Tetravac (fulldos-vaccin)? T\u00e4nker mig att de l\u00e4gre antigen-doserna i booster-vaccinet potentiellt skulle ge s\u00e4mre immunsvar? Svar: \u00c4ven om boostervaccinet inneh\u00e5ller en betydligt l\u00e4gre niv\u00e5 av difteriantigen (2 vs 20 IU) rekommenderar WHO och &hellip; <a href=\"https:\/\/resemedicin.se\/svarigar\/2025-11-19-dt-eller-dt-vid-grundimmunisering-av-vuxen\/\" class=\"more-link\">Forts\u00e4tt l\u00e4sa<span class=\"screen-reader-text\"> \u201d2025-11-19 dT eller DT vid grundimmunisering av vuxen?\u201d<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2229","post","type-post","status-publish","format-standard","hentry","category-svar-igar"],"modified_by":"Karl Ekdahl","jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/posts\/2229","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/comments?post=2229"}],"version-history":[{"count":2,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/posts\/2229\/revisions"}],"predecessor-version":[{"id":2231,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/posts\/2229\/revisions\/2231"}],"wp:attachment":[{"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/media?parent=2229"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/categories?post=2229"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/tags?post=2229"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}