The duration of protection varies by disease component, but evidence shows that these vaccines provide strong initial immunity and long-lasting immune memory, especially when booster doses are included Go to footnote 1, Go to footnote 2, Go to footnote 3, Go to footnote 4, Go to footnote 5, Go to footnote 6, Go to footnote 7, Go to footnote 8, Go to footnote 9, Go to footnote 10, Go to footnote 11, Go to footnote 12, Go to footnote 13, Go to footnote 14 .
Diphtheria - Data on the duration of seroprotection from 2 large representative population studies from the Netherlands, using a complete 3-dose primary series plus 3-dose booster series prior to adolescence, indicate
that this schedule results in very high seroprevalence above the threshold for basic protection (≥0.01 IU/mL) up to 39 years of age and potentially longer. Go to footnote 15, Go to footnote 16, Go to footnote 17
Tetanus - Data from serological studies suggest that a primary series of 3 TTCV doses in infancy plus a booster during the second year of life will provide 3–5 years of protection. A further booster dose (e.g. in early childhood) provides protection into adolescence, and another booster during adolescence induces immunity that lasts through much of adulthood, providing protection to women of reproductive age. Go to footnote 18, Go to footnote 19, Go to footnote 20
Pertussis - Whereas little is known about the duration of protection following pertussis vaccination in LMICs countries, several studies in HICs show that protection wanes after 4-12 years. Go to footnote 21, Go to footnote 22
Hepatitis B - In a study in Alaska, USA, a 3-dose vaccination schedule prevented all clinically appparent and chronic HepB infection for at least 30 years. Go to footnote 23, Go to footnote 24, Go to footnote 25, Go to footnote 26
Hib - Although there is some evidence of a decrease over time in the proportion of Hib vaccine recipients with antibody levels higher than the set thresholds, there is only limited evidence to suggest that this decline is associated with an increase in clinical disease. Go to footnote 27, Go to footnote 28
Poliomyelitis - The exact duration of immunity following a complete IPV series is not fully determined; however, it is believed to confer protection for many years. Go to footnote 29
- Go back to footnote reference 1
Diphtheria vaccine: WHO position paper, August 2017. Weekly Epidemiological Record. 2017; 92(31): 417–435.
- Go back to footnote reference 2
Tetanus vaccine: WHO position paper, February 2017. Weekly Epidemiological Record. 2017; 92(6): 53–76.
- Go back to footnote reference 3
Pertussis vaccine: WHO position paper, August 2015. Weekly Epidemiological Record. 2015; 90(35): 433–460.
- Go back to footnote reference 4
Hepatitis B vaccines: WHO position paper, July 2017. Weekly Epidemiological Record. 2017; 92(27): 369–392.
- Go back to footnote reference 5
Haemophilus influenzae type b (Hib) vaccine: WHO position paper, July 2013. Weekly Epidemiological Record. 2013; 88(39): 413–426.
- Go back to footnote reference 6
Polio vaccines: WHO position paper, June 2022. Weekly Epidemiological Record. 2022; 97(25): 277–296.7.
- Go back to footnote reference 7
Wendelboe, A.M., et al. (2005) ‘Duration of immunity against pertussis after natural infection or vaccination’, Pediatric Infectious Disease Journal, 24(Suppl. 5), pp. S58–S61.
- Go back to footnote reference 8
Borrow, R., Balmer, P. and Roper, M.H. (2007) The immunologic basis for immunization: module 3: tetanus. Geneva: World Health Organization. Available at: http://apps.who.int/iris/bitstream/10665/43687/1/9789241595551_eng.pdf (accessed 30 June 2025).
- Go back to footnote reference 9
Swart, E.M., et al. (2016) ‘Long-term protection against diphtheria in the Netherlands after 50 years of vaccination: results from a seroepidemiological study’, PLoS ONE, 11(2), e0148605. doi: 10.1371/journal.pone.0148605.
- Go back to footnote reference 10
Bruce, M.G., et al. (2016) ‘Antibody levels and protection after hepatitis B vaccine: results of a 30-year follow-up study and response to a booster dose’, Journal of Infectious Diseases, 214, pp. 16–22. doi: 10.1093/infdis/jiw144.
- Go back to footnote reference 11
Wanlapakorn, N., Sarawanangkoor, N., Srimuan, D., Thatsanathorn, T., Klinfueng, S. and Poovorawan, Y. (2024) ‘Persistence of hepatitis B surface antibody until 7 years of age following administration of hexavalent and pentavalent vaccines in children at 2, 4, 6, and 18 months’, Vaccine: X, 20. doi: 10.1016/j.jvacx.2024.100561.
- Go back to footnote reference 12
Wanlapakorn, N., Sarawanangkoor, N., Srimuan, D., Thatsanathorn, T., Thongmee, T. and Poovorawan, Y. (2024) ‘Antibody persistence to diphtheria toxoid, tetanus toxoid, Bordetella pertussis antigens, and Haemophilus influenzae type b following primary and first booster with pentavalent versus hexavalent vaccines’, Human Vaccines & Immunotherapeutics, 20. doi: 10.1080/21645515.2024.2352909.
- Go back to footnote reference 13
Avdičová, M., Crasta, P., Hardt, K. and Kovac, M. (2015) ‘Lasting immune memory against hepatitis B following challenge 10-11 years after primary vaccination with either three doses of hexavalent DTPa-HBV-IPV/Hib or monovalent hepatitis B vaccine at 3, 5 and 11-12 months of age’, Vaccine, 33(23), pp. 2727–2733. doi: 10.1016/j.vaccine.2014.06.070.
- Go back to footnote reference 14
Mangarule, S., Sapru, A., Bavdekar, A., Kawade, A., Lalwani, S., et al. (2023) ‘Antibody persistence following administration of a hexavalent DTwP-IPV-HB-PRPT vaccine versus separate DTwP-HB-PRPT and IPV vaccines and safety and immunogenicity of a booster dose of DTwP-IPV-HB-PRP~T administered with an MMR vaccine in healthy infants in India’, Pediatric Infectious Disease Journal, 42(12), pp. 1128–1135.
- Go back to footnote reference 15
Diphtheria vaccine: WHO position paper, August 2017. Weekly Epidemiological Record. 2017; 92(31): 417–435.
- Go back to footnote reference 16
Swart, E.M., et al. (2016) ‘Long-term protection against diphtheria in the Netherlands after 50 years of vaccination: results from a seroepidemiological study’, PLoS ONE, 11(2), e0148605. doi: 10.1371/journal.pone.0148605.
- Go back to footnote reference 17
Wanlapakorn, N., Sarawanangkoor, N., Srimuan, D., Thatsanathorn, T., Thongmee, T. and Poovorawan, Y. (2024) ‘Antibody persistence to diphtheria toxoid, tetanus toxoid, Bordetella pertussis antigens, and Haemophilus influenzae type b following primary and first booster with pentavalent versus hexavalent vaccines’, Human Vaccines & Immunotherapeutics, 20. doi: 10.1080/21645515.2024.2352909.
- Go back to footnote reference 18
Tetanus vaccine: WHO position paper, February 2017. Weekly Epidemiological Record. 2017; 92(6): 53–76.
- Go back to footnote reference 19
Borrow, R., Balmer, P. and Roper, M.H. (2007) The immunologic basis for immunization: module 3: tetanus. Geneva: World Health Organization. Available at: http://apps.who.int/iris/bitstream/10665/43687/1/9789241595551_eng.pdf (accessed 30 June 2025).
- Go back to footnote reference 20
Wanlapakorn, N., Sarawanangkoor, N., Srimuan, D., Thatsanathorn, T., Thongmee, T. and Poovorawan, Y. (2024) ‘Antibody persistence to diphtheria toxoid, tetanus toxoid, Bordetella pertussis antigens, and Haemophilus influenzae type b following primary and first booster with pentavalent versus hexavalent vaccines’, Human Vaccines & Immunotherapeutics, 20. doi: 10.1080/21645515.2024.2352909.
- Go back to footnote reference 21
Pertussis vaccine: WHO position paper, August 2015. Weekly Epidemiological Record. 2015; 90(35): 433–460.
- Go back to footnote reference 22
Wendelboe, A.M., et al. (2005) ‘Duration of immunity against pertussis after natural infection or vaccination’, Pediatric Infectious Disease Journal, 24(Suppl. 5), pp. S58–S61.
- Go back to footnote reference 23
Hepatitis B vaccines: WHO position paper, July 2017. Weekly Epidemiological Record. 2017; 92(27): 369–392.
- Go back to footnote reference 24
Bruce, M.G., et al. (2016) ‘Antibody levels and protection after hepatitis B vaccine: results of a 30-year follow-up study and response to a booster dose’, Journal of Infectious Diseases, 214, pp. 16–22. doi: 10.1093/infdis/jiw144.
- Go back to footnote reference 25
Wanlapakorn, N., Sarawanangkoor, N., Srimuan, D., Thatsanathorn, T., Klinfueng, S. and Poovorawan, Y. (2024) ‘Persistence of hepatitis B surface antibody until 7 years of age following administration of hexavalent and pentavalent vaccines in children at 2, 4, 6, and 18 months’, Vaccine: X, 20. doi: 10.1016/j.jvacx.2024.100561.
- Go back to footnote reference 26
Avdičová, M., Crasta, P., Hardt, K. and Kovac, M. (2015) ‘Lasting immune memory against hepatitis B following challenge 10-11 years after primary vaccination with either three doses of hexavalent DTPa-HBV-IPV/Hib or monovalent hepatitis B vaccine at 3, 5 and 11-12 months of age’, Vaccine, 33(23), pp. 2727–2733. doi: 10.1016/j.vaccine.2014.06.070.
- Go back to footnote reference 27
Haemophilus influenzae type b (Hib) vaccine: WHO position paper, July 2013. Weekly Epidemiological Record. 2013; 88(39): 413–426.
- Go back to footnote reference 28
Wanlapakorn, N., Sarawanangkoor, N., Srimuan, D., Thatsanathorn, T., Thongmee, T. and Poovorawan, Y. (2024) ‘Antibody persistence to diphtheria toxoid, tetanus toxoid, Bordetella pertussis antigens, and Haemophilus influenzae type b following primary and first booster with pentavalent versus hexavalent vaccines’, Human Vaccines & Immunotherapeutics, 20. doi: 10.1080/21645515.2024.2352909.
- Go back to footnote reference 29
Polio vaccines: WHO position paper, June 2022. Weekly Epidemiological Record. 2022; 97(25): 277–296.7.
