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Immunization of Indochinese Refugees

Richard A. Goodman, MD; Timothy F. Nolan Jr, MD; Alan R. Hinman, MD
JAMA. 1980;244(18):2046. doi:10.1001/jama.1980.03310180016015.
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To the Editor.—  In follow-up of the description of Deinard et al (243:2156, 1980) of a patient with otogenous tetanus, we would like to comment on one of their conclusions and to inform readers about an immunization program for Indochinese refugees who are coming to the United States.The recommended schedule for unimmunized children between the ages of 2 months to 7 years consists of three doses of diphtheria and tetanus toxoids and pertussis vaccine (DTP) given at four- to eight-week intervals followed by a fourth dose 12 months later and a booster dose at the time of school entry.1 These recommendations provide for optimal protective antibody titer responses. In the patient described by Deinard et al, the clinical onset of tetanus occurred within five days of immunization, and only one dose of DTP had been documented with certainty. Consequently, it is not surprising that the child had not


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