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.
| Category | Description |
|---|---|
| Type of vaccine | Toxoid (sub-unit vaccine) |
| Number of doses | Women: at least two doses – ideally five (see Table 2.7) |
| Schedule | Women: first dose at first contact during childbearing years, or as early as possible in pregnancy (then see Table 2.7) |
| Booster | Every 10 years during childbearing years |
| Contraindications | Severe 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. |
| Dosage | 0.5 ml |
| Injection site | Women: outer upper arm |
| Injection type | Intramuscular (IM) |
| Storage | Store between +2°C and +8°C. Never freeze |
| 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 |
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2.4 Tetanus toxoid (TT) vaccine