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Tetanus - the vaccine

Table of contents for Tetanus Introduction Tetanus - the disease Tetanus - the vaccine Key points and Vaccine Summary

What it TT vaccine?

Tetanus toxoid (TT) vaccine protects against tetanus. It is provided as a liquid in vials and also in prefilled auto-disable injection devices (see Module 4). It is available in a number of different formulations:

• TT vaccine protects only against tetanus and neonatal tetanus.
• DTP, or diphtheria-tetanus-pertussis vaccine, protects against diphtheria, tetanus, and pertussis (see Section 1 of this Module).
• DT, or diphtheria-tetanus toxoids vaccine, protects against diphtheria and tetanus. Because it contains high levels of diphtheria toxoid, it should not be given to children older than six years old or adults.
• Td, or tetanus-diphtheria toxoids adult dose vaccine, is the same vaccine as DT, but with a lower diphtheria toxoid dose. It is suitable for children older than six years old and adults, including pregnant women. Td has the added advantage of protecting against diphtheria and tetanus.

When given to women of childbearing age, vaccines that contain tetanus toxoid (TT or Td) not only protect women against tetanus, but also prevent neonatal tetanus in their newborn infants. When TT or Td vaccine is given to a woman who is or who becomes pregnant, the antibodies that form in her body are passed to her fetus. These antibodies protect the baby against tetanus during birth and for a few months afterwards. They also protect the woman against tetanus.

A three-dose course of TT or Td provides protection against maternal and neonatal tetanus for at least five years. A maximum of five doses will protect women throughout their childbearing years.

When vaccines containing tetanus toxoid stand for a long time, the vaccine separates from the liquid and looks like fine sand at the bottom of the vial. Shake the vial to mix the vaccine and liquid again before giving the vaccine. TT/DT/Td/DTP vaccines should never be frozen. The “Shake test" will determine if the vaccine has been damaged by freezing. If the vaccine fails the shake test you must discard it.

How safe are TT, Td and DT vaccines and what are their potential side-effects?

Vaccines containing tetanus toxoid cause very few serious reactions but quite frequent mild reactions.

Mild reactions to TT, Td, and DT vaccines include:

• Soreness. About one in ten people who receive the vaccines have mild pain, redness, warmth, and swelling at the injection site for about one to three days after the injection. This mild reaction is likely to be more common after later doses than earlier ones, and may affect between 50% and 85% of people who receive booster doses.
• Fever. About one in ten people may develop a mild fever after receiving the vaccines

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