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.
Table 2.6 Summary of tetanus toxoid (TT) vaccine characteristics in women.
|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|
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.
|Injection site||Women: outer upper arm|
|Injection type||Intramuscular (IM)|
|Storage||Store 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 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|