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Am J Public Health. 1998 June; 88(6): 903–907.
PMCID: PMC1508215

Duration of protective immunity conferred by maternal tetanus toxoid immunization: further evidence from Matlab, Bangladesh.


OBJECTIVES: Although maternal tetanus immunization has been shown to be highly effective in the prevention of neonatal tetanus, unresolved questions remain concerning the required minimum number of doses and the resulting duration of effective immunity. This study examined the duration of effective immunity against neonatal tetanus provided by maternal tetanus immunization. METHODS: A randomized, double-blind cholera vaccine trial of 41,571 children and nonpregnant adult women carried out in 1974 in the Matlab comparison area of rural Bangladesh provided a unique opportunity to address dose and immunity issues. RESULTS: Children of women who received either 1 or 2 injections of tetanus toxoid experienced 4- to 14-day mortality levels consistently lower than those of children of unimmunized mothers. Analysis of neonatal-tetanus-related mortality showed that 2 injections of tetanus toxoid provided significant protection for subsequent durations of up to 12 or 13 years. CONCLUSIONS: The data demonstrate that a limited-dose regimen of maternal tetanus toxoid provides significant and extended protection against the risk of neonatal tetanus death.

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  • Stanfield JP, Galazka A. Neonatal tetanus in the world today. Bull World Health Organ. 1984;62(4):647–669. [PMC free article] [PubMed]
  • Black RE, Huber DH, Curlin GT. Reduction of neonatal tetanus by mass immunization of non-pregnant women: duration of protection provided by one or two doses of aluminium-adsorbed tetanus toxoid. Bull World Health Organ. 1980;58(6):927–930. [PMC free article] [PubMed]
  • Newell KW, Dueñas Lehmann A, LeBlanc DR, Garces Osorio N. The use of toxoid for the prevention of tetanus neonatorum. Final report of a double-blind controlled field trial. Bull World Health Organ. 1966;35(6):863–871. [PMC free article] [PubMed]
  • Rahman M, Chen LC, Chakraborty J, Yunus M, Chowdhury AI, Sarder AM, Bhatia S, Curlin GT. Use of tetanus toxoid for the prevention of neonatal tetanus. 1. Reduction of neonatal mortality by immunization of non-pregnant and pregnant women in rural Bangladesh. Bull World Health Organ. 1982;60(2):261–267. [PMC free article] [PubMed]
  • SCHOFIELD FD, TUCKER VM, WESTBROOK GR. Neonatal tetanus in New Guinea. Effect of active immunization in pregnancy. Br Med J. 1961 Sep 23;2(5255):785–789. [PMC free article] [PubMed]
  • Kielmann AA, Vohra SR. Control of tetanus neonatorum in rural communities--immunization effects of high-dose calcium phosphate-absorbed tetanus toxoid. Indian J Med Res. 1977 Dec;66(6):906–916. [PubMed]
  • Breman JG, Wright GG, Levine L, Latham WC, Compaoré KP. The primary serological response to a single dose of adsorbed tetanus toxoid, high concentration type. Bull World Health Organ. 1981;59(5):745–752. [PMC free article] [PubMed]
  • Stanfield JP, Gall D, Bracken PM. Single-dose antenatal tetanus immunisation. Lancet. 1973 Feb 3;1(7797):215–219. [PubMed]
  • Koenig MA, Rob U, Khan MA, Chakraborty J, Fauveau V. Contraceptive use in Matlab, Bangladesh in 1990: levels, trends, and explanations. Stud Fam Plann. 1992 Nov-Dec;23(6 Pt 1):352–364. [PubMed]
  • Bhatia S. Patterns and causes of neonatal and postneonatal mortality in rural Bangladesh. Stud Fam Plann. 1989 May-Jun;20(3):136–146. [PubMed]
  • Benenson AS, Mosley WH, Fahimuddin M, Oseasohn RO. Cholera vaccine field trials in east Pakistan. 2. Effectiveness in the field. Bull World Health Organ. 1968;38(3):359–372. [PMC free article] [PubMed]
  • Mosley WH, Aziz KM, Mizanur Rahman AS, Alauddin Chowdhury AK, Ahmed A, Fahimuddin M. Report of the 1966-67 cholera vaccine trial in rural East Pakistan. Bull World Health Organ. 1972;47(2):229–238. [PMC free article] [PubMed]

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