When is TT routinely used in children?
TT is routinely used for children >10 years of age as they do not need both Diphtheria & pertussis components. It is given as a booster dose at 10 years & 16 years to children who have received their primary doses/boosters of DPT/DT before. It can be then taken every 5-10 years to maintain protection life long

When is TT given to pregnant women?
A lady who is previously unimmunised should receive 3 doses of TT during pregnancy at 1-month interval starting the first dose at 28 weeks. The last dose should be at least 30 days prior to the expected date of delivery so that there is enough time for good antibody titres to develop in mother & for it to be passed on to the fetus to prevent tetanus in newborn. During repeat pregnancy, 2 doses of TT are given at 4 weeks interval. Again the last dose is given at least 30 days before delivery.

When is TT given to an adult with injury?
An adult who has never received or has received incomplete course of TT before in life should be given 3 doses of TT at 4 weeks interval followed by a booster after 1 year & then every 5 years. If he then develops any injury or requires any surgery there is no need to take anymore TT as he is protected in between the doses. If such an adult has taken the last TT beyond 4-5 years in past, he can be given one dose of TT, which acts as a booster. It is neither required nor desirable or safe to give TT for each and every injury every now & then in such a protected person.

What if the child gets injured, should he receive TT?
A child who has received 3 primary doses of DPT/DT is protected till 15 months of age & does not need TT. If he is 15-18 months of age he should receive his first 1st booster of OPV + DPT which will also boost up anti-tetanus immunity. Such a child is protected till 4 years & does not need a TT till that age. If he is between 4-6 years he should receive his 2nd booster of DT or OPV + DPT which will boost up his anti-tetanus immunity too. Such a child is now protected till 10 years of age. After this a booster of TT is given at 10years, 16 years & every 5 years thereafter. In between such doses there is no need to give TT for injury.

What harm is done if one gives TT frequently?
If TT is given frequently, it will hyper-immunize the patient. Such a patient can develop arthus like phenomenon with development of fever, rash, joint pain, joint swelling etc. Hence it is not desirable to give frequent injections of TT in an otherwise immunized patient.

Should a patient who recovers from diphtheria or tetanus or pertussis receive vaccine against the respective disease?
Neither diphtheria, tetanus or pertussis disease leads to strong immunity. Hence, a person who has recovered from such diseases should receive 3 primary doses and boosters of DPT/DT/TT as appropriate for his age.



 

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