Title: Schedule, dosage, storage and effectiveness of TT vaccine
Course: Immunization - Ethiopia (Full)

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 +2^oC and +8^oC 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.

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

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