2.4.2  Schedule, dosage, storage and effectiveness of TT vaccine

If given as a separate vaccine to pregnant and non-pregnant women of childbearing age, at least two doses of 0.5 ml of TT vaccine are given intramuscularly (IM) into the upper arm (Figure 2.7); but for maximum long-lasting protection throughout the childbearing years women should receive more than two doses (TT2+), and the ideal is to give five doses. It should be stored at between +2oC and +8oC and never frozen. Table 2.6 summarises the characteristics of TT vaccine; the periods of protection after each dose are given in Table 2.7.

Figure 2.7  Make sure all pregnant women are immunized against tetanus.

Table 2.6  Summary of tetanus toxoid (TT) vaccine characteristics in women.

Type of vaccineToxoid (sub-unit vaccine)
Number of dosesWomen: at least two doses – ideally five (see Table 2.7)
ScheduleWomen: first dose at first contact during childbearing years, or as early as possible in pregnancy (then see Table 2.7)
BoosterEvery 10 years during childbearing years
ContraindicationsSevere allergic reaction to a previous dose, or encephalopathy
Adverse events

Paracetamol can be given to treat mild reactions, but avoid giving any medication to pregnant women.

Mild reactions, e.g. low-grade fever, soreness, redness and pain at the injection site: usually disappears after 1–3 days.
Dosage0.5 ml
Injection siteWomen: outer upper arm
Injection typeIntramuscular (IM)
StorageStore between +2°C and +8°C. Never freeze

Table 2.7  Duration of protection in women following 1–5 doses of TT vaccine.

Dose (0.5ml)When givenDuration of protection
TT1At first contact with women of childbearing age, or as early as possible in the pregnancyNo protection
TT2At least 4 weeks after TT13 years
TT3At least 6 months after TT25 years
TT4At least 1 year after TT310 years
TT5At least 1 year after TT4All childbearing years

2.4  Tetanus toxoid (TT) vaccine

2.4.3  Adverse events and contraindications of TT vaccine