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.

CategoryDescription
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

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

Dose (0.5ml)When givenDuration 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
Last modified: Saturday, 12 July 2014, 4:50 PM