Tetanus Toxoid (TT) Vaccine in Pregnancy – Benefits, Schedule and Side Effects

Tetanus toxoid for pregnant women is important and considered safe when recommended by a healthcare professional. It helps protect the mother from tetanus and can also provide the baby with protective antibodies before birth. According to the WHO, more than 7,700 newborns died from neonatal tetanus in 2021, although deaths have fallen by 84% since 2000, largely due to increased vaccination (1).

But when should the TT vaccine be taken, and how many doses are needed during pregnancy? This article covers the importance, safety, ideal timing, doses, and key precautions related to the TT vaccine during pregnancy.

What Is Tetanus Toxoid?

Tetanus toxoid (TT) is a vaccine which helps prevent a person from getting a tetanus infection. A TT vaccine can also prevent a pregnant woman and her baby from getting a tetanus infection. If you are pregnant, your doctor will also recommend this vaccine. After administering this vaccine, antibodies will get formed in your body which will then get passed on to your child and protect him for some time (2).

What Is Neonatal Tetanus?

Neonatal tetanus is an extremely deadly condition that is harmful to newborns. This condition mostly occurs due to the use of unsterilized cutting instruments and unhealed umbilical cord stumps. Newborns get affected as they have a weak immune system. Therefore, it is essential for a woman to get a Tetanus Toxoid vaccine during pregnancy. This vaccine will keep the baby immune for some time after delivery (3).

Why It Is Important to Take Tetanus Toxoid (TT) Vaccine in Pregnancy?

Getting a tetanus injection during pregnancy is mandatory. Women who have had a tetanus-prone wound should get a Tetanus Toxoid vaccine to avoid the risk of tetanus disease. It is also recommended to give Tetanus Toxoid vaccines in underdeveloped regions since deliveries happen in unhygienic conditions. Many countries follow a universal standard for Tetanus Toxoid (TT) immunisation for pregnant women (4).

Is Tetanus Toxoid(TT) Vaccine Safe During Pregnancy?

Yes, the Tetanus Toxoid (TT) vaccine is considered safe during pregnancy and is recommended as part of routine prenatal care in many countries. It helps protect both the pregnant person and their baby from tetanus, a serious bacterial infection that can be fatal. The TT vaccine is typically given in a series of doses during pregnancy to ensure adequate protection. It’s important to discuss any concerns with your healthcare provider, but generally, the benefits of vaccination outweigh the risks associated with tetanus infection during pregnancy (5).

What Is the Difference Between TT, Td and Tdap Vaccines?

Here’s a simple comparison to help you see how TT, Td, and Tdap differ in terms of protection and their key components (6):

What Is the Best Time for a Pregnant Woman to Receive a TT Vaccination?

According to guidelines from the American College of Obstetricians and Gynecologists (ACOG), the optimal time for receiving the Tdap vaccination is typically between the 27th and 36th weeks of pregnancy. This timeframe is chosen to enhance both maternal immune response and the transfer of antibodies to the newborn. Nevertheless, the Tdap vaccine can be safely administered at any point during pregnancy (7).

In certain circumstances or urgent situations, healthcare providers may recommend earlier or later administration of the Tdap vaccine. 

What Steps Should Be Followed Before Taking TT Vaccination When Pregnant?

Before taking the Tetanus Toxoid (TT) vaccine during pregnancy, it’s important to follow these steps:

1. Consultation With Healthcare Provider: Discuss with your healthcare provider to confirm the need for the TT vaccine and to understand its benefits and potential risks in your specific case.
2. Medical History Review: Provide your complete medical history, including any allergies or previous adverse reactions to vaccines.
3. Physical Examination: Undergo a physical examination to ensure there are no contraindications to receiving the TT vaccine.
4. Verification of Vaccine Integrity: Ensure that the vial containing the TT vaccine is vigorously shaken by the administering healthcare provider. This shaking helps to mix any sediments that may have formed with the fluid, ensuring the vaccine is properly prepared. It’s crucial because vaccines that have been thawed and refrozen or have visible sediments should not be used for injection, as they may be ineffective or unsafe.
5. Consent: Provide informed consent before receiving the vaccine, understanding its purpose, potential side effects, and benefits.
6. Observation: Remain under observation for a short period after receiving the vaccine to monitor for any immediate adverse reactions.

TT Vaccination Schedule for Pregnant Women

American Congress of Obstetrics and Gynaecologists (ACOG) recommend the following vaccine for tetanus toxoid in pregnancy schedule to expectant women. The vaccination will be administered only after your healthcare provider has completely screened your reports (8).

So this was the schedule for the 1st TT in pregnancy, 2nd dose of TT, and the subsequent doses.

If the pregnant woman has never been vaccinated before or her immunization results are not known, 2 doses of TT/Td are administered 1 month prior to the birth of her baby and further doses according to the table above.

If the expectant woman had been administered 1 – 4 tetanus toxoid doses earlier, the remaining dose of TT/Td can be administered before the birth of the child. If the expectant woman shows proof of vaccinations of her adolescence, childhood and infancy of TT, DTP, DT or Td vaccines, doses will be given according to the table below.

The final vaccination of TT for pregnancy should be administered 2 weeks before giving birth. The dosages are noted on a personal vaccination card that one must keep safe.

How Many Doses of the Tetanus Vaccine Are Given to Pregnant Women?

Tetanus vaccination is a crucial component of prenatal care, aiming to safeguard both pregnant individuals and their newborns from tetanus, a severe and potentially deadly bacterial infection. Understanding the recommended number of doses during pregnancy is essential for ensuring adequate protection for both mother and child.

TT Vaccine During First Pregnancy

Your doctor will prescribe you 2 doses of tetanus toxoid in pregnancy in case of your first pregnancy.

• The first dosage will be administered in the third trimester, that will be somewhere around the seventh month of pregnancy.
• The second dosage will be administered after 4 weeks of the first vaccine.
• The World Health Organization recommends a third dosage which is given after 6 months of the second dose. This is provided to offer a shield against the tetanus bacteria for at least 5 years.

Few health care providers also prefer giving 3 doses, then first at 28 weeks of pregnancy. While some prefer in the first trimester when all the other tests are confirmed.

TT Vaccine During Second Pregnancy

Your doctor will check your entire vaccination history, and then he will prescribe the injection TT in pregnancy.

• If your second pregnancy is within 2 years of your first pregnancy, and you have been administered 2 doses of vaccine in the first pregnancy, then you will only be given 1 booster vaccine.
• If your second pregnancy happens after a long gap, the schedule of vaccination will differ.

What Are the Possible Side Effects of Taking Tetanus Toxoid Vaccination in Pregnancy?

While the Tetanus toxoid vaccine is generally safe, it can lead to some mild side effects, most of which are temporary and manageable. Understanding these potential TT injection during pregnancy side effects can help individuals make informed decisions about their health care (9).

1. Pain or Redness at the Injection Site

It’s common to experience mild pain, swelling, or redness at the site where the vaccine was administered. This discomfort usually resolves on its own within a few days and can be alleviated with a cold compress or over-the-counter pain relievers.

2. Low-Grade Fever

Some individuals may develop a slight fever shortly after receiving the tetanus toxoid vaccine. This is a natural response as the body’s immune system reacts to the vaccine components. Fever is usually mild and goes away within a day or two without any specific treatment needed.

3. Fatigue

Feeling tired or experiencing mild fatigue can occur after vaccination. This is often temporary and may be related to the body’s immune response to the vaccine.

4. Headache

Headaches are occasionally reported post-vaccination. These headaches are typically mild and transient, resolving on their own without specific intervention.

5. Nausea or Vomiting

Some pregnant women may experience mild nausea or vomiting after receiving the vaccine. These symptoms are usually short-lived and can be managed with rest and hydration.

6. Muscle Aches

Pain or discomfort in the muscles, especially near the injection site, can occur. This discomfort is generally mild and temporary, similar to the soreness experienced after other types of vaccinations.

7. Allergic Reactions

Although rare, allergic reactions can occur following tetanus toxoid vaccination. Symptoms may include hives, itching, difficulty breathing, or swelling of the face and throat. These reactions require immediate medical attention. It’s important to notify your healthcare provider of any history of severe allergies before receiving the vaccine.

8. Joint Pain

Some individuals may experience mild joint pain or stiffness after vaccination. This is uncommon but can occur as part of the body’s immune response. It typically resolves quickly without specific treatment.

FAQs

1. Is the tetanus toxoid vaccine effective if I’ve had tetanus shots before pregnancy?

If you’ve had a complete series of tetanus shots before pregnancy, you likely have sufficient immunity. However, a booster dose during pregnancy ensures continued protection and enhances passive immunity for the newborn.

2. What should I do if I miss my scheduled tetanus toxoid vaccine dose during pregnancy?

If you miss a scheduled tetanus toxoid vaccine dose during pregnancy, consult your healthcare provider promptly. They will advise on the best course of action, which may involve rescheduling the dose to maintain optimal protection for you and your baby.

3. Can I receive other vaccinations alongside the tetanus toxoid vaccine during pregnancy?

Depending on your healthcare provider’s recommendations and specific vaccine schedules, other vaccines may be administered concurrently with the tetanus toxoid vaccine during pregnancy. It’s essential to discuss this with your healthcare provider to ensure safety and effectiveness.

Getting vaccinated by the Tetanus Toxoid (TT) vaccine during pregnancy is essential to make sure that both the mother and child stay safe. So, if you are pregnant, get this vaccine administered and keep yourself and your child safe.

Also Read: 

HCG Injection while Pregnant
Anti-D Injection Dose in Pregnancy
Betnesol Injection during Pregnancy

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Sources References

1. World Health Organization – Tetanus

2. Mayo Clinic – Tetanus toxoid (intramuscular route, injection route)

3. World Health Organization – Neonatal tetanus: risk communication and community engagement guidance

4. Immunization Technical Support Unit – FAQs On Vaccination of Pregnant Women

5. PubMed Central – Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine (Tdap) in Pregnant Women — Advisory Committee on Immunization Practices (ACIP), 2012

6. Centers for Disease Control and Prevention – Types of Tetanus Vaccines

7. American College of Obstetricians and Gynecologists – Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination

8. Centers for Disease Control and Prevention – Guidelines for Vaccinating Pregnant Women

9. Cleveland Clinic – Tetanus Shot

10. Cleveland Clinic – Tetanus (Lockjaw)

11. NHS – Vaccinations in pregnancy