Tetanus toxoid vaccine example

Tetanus is caused by bacteria that enter the body through open wounds. The bacteria cause an increased tightening of muscles, resulting in spasms, stiffness, and arching of the spine. Ultimately, breathing becomes more difficult, and spasms occur more frequently.

People of all ages can get tetanus. But the disease is particularly common and serious in newborn babies. This is called neonatal tetanus. Most infants who get the disease die. Neonatal tetanus is particularly common in rural areas where most deliveries are at home without adequate sterile procedures. WHO estimated that neonatal tetanus killed about 128 000 babies in 2004.74

Tetanus can be prevented by immunizing women of childbearing age with tetanus toxoid, either during pregnancy or before pregnancy. This protects the mother and – through a transfer of tetanus antibodies to the fetus – also her baby.

People who recover from tetanus do not have natural immunity and can be infected again and therefore need to be immunized. To be protected throughout life, an individual should receive three doses of DTP in infancy, followed by a booster containing tetanus toxoid (TT) – at school-entry age (4–7 years), in adolescence (12–15 years), and in early adulthood.

The table below demonstrates the duration of protection against tetanus in women who missed the TT vaccination as infants and then received catch-up immunization during their childbearing years (usually taken to be from 15 to 49 years).

Duration of protection in women after 1–5 doses of TT vaccine

Dose (0.5ml) When given Duration of protection
TT1 At first contact with women of childbearing age, or as early as possible in the pregnancy No protection
TT2 At least 4 weeks after TT1 3 years
TT3 At least 6 months after TT2 5 years
TT4 At least 1 year after TT3 10 years
TT5 At least 1 year after TT4 All childbearing years