The primary immunizing course for unimmunised individuals 7 years of age or older consists of two doses or 0.5 mL each 4 to 8 weeks apart followed by a third (reinforcing) dose of 0.5 mL, 6 to 12 months after the second dose. The reinforcing dose is an integral part of primary immunizing course. Individuals who have not completed primary immunization against tetanus, or whose immunization history is unknown or uncertain, should be immunized with a tetanus toxoid containing-product.
TT may be given at the same time as BCG, measles, rubella, mumps, polio (OPV and IPV), hepatitis B, Haemophilus influenzae
type b, and yellow fever vaccines and vitamin A supplementation.
For neonatal tetanus prevention:
Antenatal immunization is recommended for the prevention of neonatal tetanus in the previously unimmunized mother. A previously unimmunized pregnant woman who may deliver her child under non hygienic circumstances and/or surroundings should receive two doses of a tetanus toxoid-containing preparation before delivery (4 to 8 weeks apart), preferably during the last 2 trimesters. Incompletely immunized pregnant women should complete the 3 dose series. Those immunized more than 10 years previously should have a booster dose. (See Table.)
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In tetanus prophylaxis in wound management:
The need for active immunization with a tetanus toxoid-containing preparation, with or without passive immunization with TIG (Human) depends on both the condition of the wound and the patient's vaccination history. Tetanus toxoid vaccine in conjunction with tetanus immune globulin is recommended for prophylactic contaminated wound management in unimmunized, uncertain, or incomplete immunization status patients.
A thorough attempt must be made to determine whether a patient has completed primary immunization. Individuals who have completed primary immunization against tetanus, and who sustain wounds which are minor and uncontaminated, should receive a booster dose of a tetanus toxoid-containing preparation only if they have not received tetanus toxoid within the preceding 10 years.
For tetanus prone wounds (e.g. wounds contaminated with dirt, faeces, soil, and saliva; puncture wounds; avulsions; and wounds resulting from missiles, crushing, burns, and frostbite), a booster is appropriate if the patient has not received a tetanus toxoid-containing preparation within the preceding 5 years. If a booster dose is given sooner than 10 years as part of wound management the next routine booster should not be given for 10 years thereafter.
Human Immunodeficiency Virus (HIV) infected persons:
HIV-infected persons, both asymptomatic and symptomatic, should be immunized with Adsorbed Tetanus vaccine according to standard schedules.
Method of administration:
The vaccine should be administered by intramuscular injection.
The vaccine ampoule should be shaken before use to homogenize the suspension. A sterile needle and a sterile syringe should be used for each injection.