Tetanus toxoid vaccination
Tetanus is an acute disease caused by an exotoxin produced by Clostridium tetani.
Neonatal infection usually occurs through the exposure of the unhealed umbilical
cord stump to tetanus spores, which are universally present in soil, and newborns
need to have received maternal antibodies via the placenta to be protected at
birth. Neonatal disease usually presents within the first two weeks of life and
involves generalized rigidity and painful muscle spasms, which in the absence of
medical treatment leads to death in most cases.
Tetanus toxoid vaccination is recommended for all pregnant women, to prevent
neonatal mortality from tetanus. If a pregnant woman has not previously been
vaccinated, or if her immunization status is unknown, she should receive two
doses of a tetanus toxoid- one month apart. Two doses protect against tetanus
infection for 1–3 years in most people. A third dose is recommended six months
after the second dose, which should extend protection to at least five years.
–– Two further doses for women who are first vaccinated against tetanus during
pregnancy should be given after the third dose, in the two subsequent years or
during two subsequent pregnancies.
–– If a woman has had 1–4 doses of a TT in the past, she should receive one dose
of a TT during each subsequent pregnancy to a total of five doses (five doses
protects throughout the childbearing years).
Mechanism of action
The type of vaccination for this disease is called artificial active immunity. This
type of immunity is generated when a dead or weakened version of the disease
enters the body, causing an immune response which includes the production of
antibodies. This is beneficial because it means that if the disease is ever
introduced into the body, the immune system will recognize the antigen and
produce antibodies more rapidly.
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