Tetanus vaccines: WHO position paper, February 2017 – Recommendations

World Health Organization

doi:10.1016/j.vaccine.2017.02.034

Cited by 110Diphtheria, Corynebacterium, and TetanusBacterial Infections and VaccinesVaccine Coverage and Hesitancy

Tetanus vaccines: WHO position paper, February 2017 – Recommendations

World Health Organization·2018·Vaccine

DOI 10.1016/j.vaccine.2017.02.034

Open this paper in CoChat — free account

Abstract

This article presents the World Health Organization's (WHO) recommendations on the use of tetanus toxoid (TT) vaccines excerpted from the WHO position paper on tetanus vaccines - February 2017, published in the Weekly Epidemiological Record [1]. This position paper replaces the May 2006 WHO position paper on tetanus vaccines (Tetanus vaccines: WHO position paper, 2006). The position paper summarizes the recent developments in the field of tetanus prevention and provides revised guidance on the optimal timing of recommended tetanus vaccine booster doses. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of the scientific evidence, and to the evidence-to-recommendation table. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. Recommendations on the use of TT-containing vaccines (TTCVs) were discussed by SAGE in October 2016; evidence presented at the meeting can be accessed at: http://www.who.int/immunization/sage/meetings/2016/october/presentations_background_docs/en/.

Integrity signals

Registry

Crossref · 10.1016/j.vaccine.2017.02.034

Cites

0 of 4 references verified0 citation errors · 4 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Provision of five or six doses of tetanus or diphtheria vaccine in childhood provides lifelong protection.
“It is known that provision of five or six doses of tetanus45 or diphtheria46 vaccine in childhood provides lifelong protection”
From A guide to vaccinology: from basic principles to new developments (2021) · cites this paper as [45]

Tetanus vaccines: WHO position paper – February 2017, Weekly epidemiological record, No. 6, 92; 2017. p. 53–76.
(n.d.)
Unresolved
Tetanus vaccines: WHO position paper – May 2006, Weekly epidemiological record, No. 20; 2006. p. 198–208.
(n.d.)
Unresolved
Evidence-to-recommendation table for tetanus vaccine. Available at: <http://www.who.int/immunization/policy/position_papers/tetanus/en/> [accessed February 2017].
(n.d.)
Unresolved
Reducing pain at the time of vaccination: WHO position paper – September 2015, Weekly epidemiological record, No. 39; 2015. p. 505–10.
(n.d.)
Unresolved

Flagged first, then by citations

4 of the 4 references couldn’t be matched to a known paper.

Sorted by citations

A guide to vaccinology: from basic principles to new developments
Pollard, A. J., & Bijker, E. M. (2021) · Nature Reviews Immunology · doi:10.1038/s41577-020-00479-7 · Cited by 1,593 · see citing works
The Protective Role of Maternal Immunization in Early Life
Cinicola, B. L., Conti, M. G., Terrin, G., Sgrulletti, M., Elfeky, R., Carsetti, R., Salinas, A. F., Mortari, E. P., Brindisi, G., Curtis, M. D., et al. (2021) · Frontiers in Pediatrics · doi:10.3389/fped.2021.638871 · Cited by 76 · see citing works
“Vaccines for pregnant women…?! Absurd” – Mapping maternal vaccination discourse and stance on social media over six months
Martin, S., Kilich, E., Dada, S., Kummervold, P. E., Denny, C., Paterson, P., & Larson, H. J. (2020) · Vaccine · doi:10.1016/j.vaccine.2020.07.072 · Cited by 66 · see citing works
Antenatal visits are positively associated with uptake of tetanus toxoid and intermittent preventive treatment in pregnancy in Ivory Coast
Yaya, S., Kota, K., Buh, A. W., & Bishwajit, G. (2019) · BMC Public Health · doi:10.1186/s12889-019-7847-1 · Cited by 56 · see citing works
A systematic review of the agreement of recall, home-based records, facility records, BCG scar, and serology for ascertaining vaccination status in low and middle-income countries
Dansereau, E., Brown, D., Stashko, L., & Danovaro-Holliday, M. C. (2020) · Gates Open Research · doi:10.12688/gatesopenres.12916.2 · Cited by 55 · see citing works
Maternal Immunization: Nature Meets Nurture
Saso, A., & Kampmann, B. (2020) · Frontiers in Microbiology · doi:10.3389/fmicb.2020.01499 · Cited by 53 · see citing works
Health Promotion and Chronic Disease Prevention at the Workplace
Andersen, L. L. (2023) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-060222-035619 · Cited by 50 · see citing works
Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach
Kajungu, D., Muhoozi, M., Stark, J. H., Weibel, D. M., & Sturkenboom, M. (2020) · PLoS ONE · doi:10.1371/journal.pone.0243834 · Cited by 37 · see citing works
Increasing Frequency of Antenatal Care Visits May Improve Tetanus Toxoid Vaccination Coverage in Pregnant Women in Pakistan
Iqbal, S., Ali, I., Ekmekçioğlu, C., et al. (2020) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2019.1705693 · Cited by 35 · see citing works
Quantitative modeling of the effect of antigen dosage on B-cell affinity distributions in maturating germinal centers
Molari, M., Eyer, K., Baudry, J., Cocco, S., & Monasson, R. (2020) · eLife · doi:10.7554/elife.55678 · Cited by 32 · see citing works
A systematic review of the agreement of recall, home-based records, facility records, BCG scar, and serology for ascertaining vaccination status in low and middle-income countries
Dansereau, E. A., Brown, D. W., Stashko, L., & Danovaro-Holliday, M. C. (2019) · Gates Open Research · doi:10.12688/gatesopenres.12916.1 · Cited by 32 · see citing works
“Serology has an obvious added value when a decision should be based on population immunity, for example for disease elimination purposes 13,60 .”
Vaccination in post-tuberculosis lung disease management: A review of the evidence
Nasiri, M. J., Silva, D. R., Rommasi, F., et al. (2023) · Pulmonology · doi:10.1016/j.pulmoe.2023.07.002 · Cited by 24 · see citing works
“Based on WHO recommendations, 98 administration of the ﬁ rst dose of tetanus toxoid should be initiated in infancy at six weeks of age, and the second dose must be injected at least four weeks apart.”
Maternal immunization in Malawi: A mixed methods study of community perceptions, programmatic considerations, and recommendations for future planning
Fleming, J. A., Munthali, A., Ngwira, B. M., et al. (2019) · Vaccine · doi:10.1016/j.vaccine.2019.06.020 · Cited by 21 · see citing works
Maternal and Neonatal Tetanus Elimination: Where are We Now?
Dhir, S., Dewan, P., & Gupta, P. (2021) · Research and Reports in Tropical Medicine · doi:10.2147/rrtm.s201989 · Cited by 19 · see citing works
Tetanus Toxoid Immunization Status and Associated Factors among Mothers in Hawzen, Eastern Zone of Tigray, Ethiopia, 2019
Mengesha, M. B., Weldegeorges, D. A., Assefa, N. E., et al. (2020) · The Open Public Health Journal · doi:10.2174/1874944502013010281 · Cited by 18 · see citing works
Modular adjuvant-free pan-HLA-DR-immunotargeting subunit vaccine against SARS-CoV-2 elicits broad sarbecovirus-neutralizing antibody responses
Kassardjian, A., Sun, E., Sookhoo, J. R. V., Muthuraman, K., Boligan, K. F., Kucharska, I., Rujas, E., Jetha, A., Branch, D. R., Babiuk, S., et al. (2023) · Cell Reports · doi:10.1016/j.celrep.2023.112391 · Cited by 17 · see citing works
Prevalence and correlates of tetanus toxoid uptake among women in sub-Saharan Africa: Multilevel analysis of demographic and health survey data
Aboagye, R. G., Amu, H., Dowou, R. K., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0296174 · Cited by 16 · see citing works
Genetically detoxified tetanus toxin as a vaccine and conjugate carrier protein
Chang, M.-J., Ollivault, M., Schuman, R. F., Nguyen, S. N., Kaltashov, I. A., Bobst, C. E., Rajagopal, S. P., Przedpelski, A., Barbieri, J. T., & Lees, A. (2022) · Vaccine · doi:10.1016/j.vaccine.2022.07.011 · Cited by 16 · see citing works
Systematic Review and Meta-Analysis on the Frequency of Antibiotic-Resistant Clostridium Species in Saudi Arabia
Banawas, S. (2022) · Antibiotics · doi:10.3390/antibiotics11091165 · Cited by 15 · see citing works
Waning rate of immunity and duration of protective immunity against diphtheria toxoid as a function of age and number of doses: Systematic review and quantitative data analysis
Kitamura, N., Bahkali, K., Chem, E. D., Quilty, B. J., Edwards, T., Toizumi, M., & Yoshida, L. (2022) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2022.2099700 · Cited by 15 · see citing works
“Figure was adapted from “WHO immunological basis for immunization series: module 3 tetanus”.(51) HUMAN VACCINES & IMMUNOTHERAPEUTICS e2099700-3”
Method
The Reliability of Anamnestic Data in the Management of Clostridium Tetani Infection in Elderly
Savioli, G., Ceresa, I. F., Giordano, M., Ferrari, I., Varesi, A., Floris, V., Esposito, C., Croesi, B., Ricevuti, G., Calvi, M., et al. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.684594 · Cited by 13 · see citing works
Predictors of Tetanus Vaccine Uptake among Pregnant Women in Khartoum State, Sudan: A Hospital-Based Cross-Sectional Study
Ibrahim, Z. A., Sabahelzain, M. M., Elhadi, Y. A. M., et al. (2023) · Vaccines · doi:10.3390/vaccines11071268 · Cited by 13 · see citing works
High-Throughput IgG Epitope Mapping of Tetanus Neurotoxin: Implications for Immunotherapy and Vaccine Design
De-Simone, S. G., Napoleão-Pêgo, P., Lechuga, G. C., Carvalho, J. P. R. S., Gomes, L. R., Cardozo, S. V., Morel, C. M., Provance, D. W., & da Silva, F. R. (2023) · Toxins · doi:10.3390/toxins15040239 · Cited by 13 · see citing works
Vaccination in pregnancy – The when, what and how?
Dad, N., Buhmaid, S., & Mulik, V. (2021) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2021.08.009 · Cited by 11 · see citing works
Recombinant monoclonal antibody siltartoxatug versus plasma-derived human tetanus immunoglobulin for tetanus: a randomized, double-blind, active-controlled, phase 3 trial
Liang, Z., Liu, S., Guo, W., et al. (2025) · Nature Medicine · doi:10.1038/s41591-025-03791-8 · Cited by 11 · see citing works
“The World Health Organization (WHO) recommends that passive immunization therapy be readily available in all countries for tetanus prophylaxis and treatment 5 .”
Vaccines: An Important Tool for Infectious Disease
Saman, S., Chauhan, I., & Srivastava, N. (2022) · Recent Advances in Anti-Infective Drug Discovery · doi:10.2174/2772434418666221114113036 · Cited by 11 · see citing works
Gender-responsive language in the National Policy Guidelines for Immunization in Kenya and changes in prevalence of tetanus vaccination among women, 2008–09 to 2014: A mixed methods study
Dutta, T., Agley, J. D., Lin, H., & Xiao, Y. (2021) · Women s Studies International Forum · doi:10.1016/j.wsif.2021.102476 · Cited by 12 · see citing works
Factors Affecting Maternal Tetanus Vaccination in Dakahlia Governorate, Egypt
Ahmed, A., & El-Berrawy, M. (2019) · Journal of High Institute of Public Health · doi:10.21608/jhiph.2019.29463 · Cited by 10 · see citing works
Factors associated with tetanus vaccination in pregnant women living in Minas Gerais State, Brazil: A cross-sectional study
Faria, A. P. V., da Silva, T. P. R., Vieira, E. W. R., Lachtim, S. A. F., Rezende, E. M., & Matozinhos, F. P. (2021) · Public Health in Practice · doi:10.1016/j.puhip.2021.100203 · Cited by 9 · see citing works
Neonatal tetanus with good outcomes at a regional referral hospital in Eastern Uganda: a case report
Nakubulwa, C., Opio, E., Alekat, G. S., et al. (2022) · Journal of Medical Case Reports · doi:10.1186/s13256-022-03255-4 · Cited by 10 · see citing works
Tetanus vaccination status in construction workers: results from an institutional surveillance campaign.
Riccò, M., Vezzosi, L., Cella, C., et al. (2019) · Acta bio-medica dell'Ateneo parmense/Acta biomedica · doi:10.23750/abm.v90i2.6759 · Cited by 9 · see citing works
Maternal immunization: trends in South and Southeast Asian countries
Kamath, G. D., Kukreja, S., Mukherjee, P., Kolhapure, S., & Sathyanarayanan, S. (2021) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2021.1974389 · Cited by 9 · see citing works
Vaccination: Adherence and Hesitancy among Pregnant Women for COVID-19, Pertussis, and Influenza Vaccines
Filip, G., Sala, A., Modolo, V., et al. (2024) · Vaccines · doi:10.3390/vaccines12040427 · Cited by 8 · see citing works
“The World Health Organization (WHO) recommends that pregnant women be vaccinated against several diseases, including seasonal influenza, tetanus, and pertussis [6–8].”
Background
Clinical Decision Support Reduces Unnecessary Tetanus Vaccinations in the Emergency Department
Dutta, S., McEvoy, D. S., Stump, T., McCabe, J., Mahendra-Rajah, A., McMurry, R., White, B. A., & Rubins, D. M. (2021) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2021.02.021 · Cited by 8 · see citing works
Modern management of maxillofacial trauma in the emergency department
Piccini, G. B., Sfondrini, D., Tomulescu, S.-A., Esposito, C., Piccioni, A., Caputo, G., Voza, A., Zanza, C., Longhitano, Y., & Savioli, G. (2025) · World Journal of Emergency Medicine · doi:10.5847/wjem.j.1920-8642.2026.003 · Cited by 7 · see citing works
Tetanus seroprotection among children in the Democratic Republic of the Congo, 2013–2014
Cheng, A., Ghanem-Uzqueda, A., Hoff, N. A., Ashbaugh, H. R., Doshi, R. H., Mukadi, P. K., Budd, R., Higgins, S. G., Randall, C., Gerber, S., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0268703 · Cited by 7 · see citing works
Immunogenicity and reactogenicity of a booster dose of a typhoid conjugate vaccine (TCV) in Malawian pre-school children
Nampota-Nkomba, N., Nyirenda, O. M., Datta, S., et al. (2025) · EClinicalMedicine · doi:10.1016/j.eclinm.2025.103100 · Cited by 6 · see citing works
A literature review and evidence-based evaluation of the Dutch national immunisation schedule yield possibilities for improvements
Pluijmaekers, A. J. M., Steens, A., Houweling, H., Rots, N. Y., Benschop, K., van Binnendijk, R. S., Bodewes, R., Brouwer, J. G. M., Buisman, A., Duizer, E., et al. (2024) · Vaccine X · doi:10.1016/j.jvacx.2024.100556 · Cited by 6 · see citing works
“Uncertainties about the correlate of protection for tetanus hamper assessment of population-wide protection [27,28] (1:ii,iii).”
Background
Comprehensive Health Insurance and access to maternal healthcare services among Peruvian women: a cross-sectional study using the 2021 national demographic survey
Rosas, E. R., Winkler, V. F., Huicho, L., Blas, M. M., Brenner, S., & Allegri, M. D. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-06086-3 · Cited by 6 · see citing works
Determinants of policy and uptake of national vaccine programs for pregnant women: results of mixed method study from Spain, Italy, and India
Privor-Dumm, L. A. (2020) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2020.1831858 · Cited by 6 · see citing works
Humoral immunity to tetanus, diphtheria and polio in adults after treatment for hematological malignancies
Einarsdottir, S., Ljungman, P. T., KAIJSER, B., et al. (2019) · Vaccine · doi:10.1016/j.vaccine.2019.11.034 · Cited by 6 · see citing works
Neonatal tetanus in St. Mary’s Hospital Lacor: A case report
Okidi, R., Sambo, V. D. C., & Eyul, J. (2020) · Clinical Case Reports · doi:10.1002/ccr3.3091 · Cited by 6 · see citing works
Review of the unmet medical need for vaccination in adults with immunocompromising conditions: An Indian perspective
Vaid, A. K., Rastogi, N., Doherty, T. M., Martin, P. F. M. S., & Chugh, Y. (2023) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2023.2224186 · Cited by 6 · see citing works
Case Series of Tetanus Diagnosis and Management in Hargeisa City
Hassan, A., Ibrahim, C., Mustafe, M., et al. (2020) · Clinical Medical Reviews and Case Reports · doi:10.23937/2378-3656/1410312 · Cited by 5 · see citing works
Investigation of the baseline tetanus antibody level and its persistence in a military unit
Tong, L., Jia, Q., Li, B., Li, Z., Qi, J., Guo, Z., & Liu, Y. (2021) · Vaccine · doi:10.1016/j.vaccine.2021.06.026 · Cited by 5 · see citing works
Immunization technologies: Time to consider new preventative solutions for respiratory syncytial virus infections
Weil-Olivier, C., Salisbury, D., Navarro-Alonso, J.-A., et al. (2023) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2023.2209000 · Cited by 5 · see citing works
Pharmacovigilance for Vaccines Used in Pregnancy: A Gap Analysis From Uganda
Nambasa, V. P., Ssebagereka, A., Ssali, A., et al. (2025) · The Pediatric Infectious Disease Journal · doi:10.1097/inf.0000000000004705 · Cited by 4 · see citing works
Advances, opportunities and challenges in developing therapeutic cancer vaccines
Duan, Z., Yang, D., Yuan, P., Dai, X., Chen, G., & Wu, D. (2023) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2023.104198 · Cited by 4 · see citing works
Tetanus Following Canine Bite in Japan: A Case Report and Literature Review
Hirai, J., Mori, N., Shibata, Y., et al. (2023) · Infection and Drug Resistance · doi:10.2147/idr.s442279 · Cited by 4 · see citing works
A genetically engineered neuronal membrane-based nanotoxoid elicits protective immunity against neurotoxins
Guo, Z., Zhu, A. T., Wei, X., et al. (2024) · Bioactive Materials · doi:10.1016/j.bioactmat.2024.05.006 · Cited by 4 · see citing works
“One such example of this approach is the tetanus toxoid vaccine [9], which is formulated using formalin-inactivated tetanus toxin and has been shown to offer long-lasting protection in those who are fully vaccinated [10].”
Background
Humoral Immunity and Antibody Responses against Diphtheria, Tetanus, and Pneumococcus after Immune Effector Cell Therapies: A Prospective Study
Angelidakis, G., Chemaly, R. F., Sahasrabhojane, P. V., et al. (2024) · Vaccines · doi:10.3390/vaccines12091070 · Cited by 4 · see citing works
“…and diphtheria of 0.01 IU/m, whereas some publications considered titers between 0.01 and 0.099 IU/mL as basic protection or undetermined seroprotective levels [25–28], and others have defined >0.1 IU/mL as the seroprotective determined by the standard toxin neutralization method [27,29–31].”
Influential
Long-Term Immunity Against Tetanus and Diphtheria after Vaccination of Allogeneic Stem Cell Transplantation Recipients
Einarsdottir, S., Sverrisdottir, I. S., Vaht, K., Bergström, T. B., Brune, M. L., Andersson, P., Wennerås, C., & Ljungman, P. T. (2023) · Transplantation and Cellular Therapy · doi:10.1016/j.jtct.2023.01.023 · Cited by 4 · see citing works
Recent trends in the development of bacterial and fungal vaccines
Mir, M. A., Usman, M., Qadri, H., & Aisha, S. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-96127-1.00003-6 · Cited by 4 · see citing works
Trends and Hospitalization Outcomes of Tetanus Cases: A Multicenter Retrospective Study in Suzhou, 2013–2023
Yu, J., Zheng, B., Liu, N., et al. (2024) · Risk Management and Healthcare Policy · doi:10.2147/rmhp.s487340 · Cited by 3 · see citing works
Safety and Immunogenicity of Vaccines in Children with Kaposiform Hemangioendothelioma Receiving Sirolimus: A Prospective Study
Yuan, J., Yuan, Z., Ding, Y., et al. (2025) · Vaccines · doi:10.3390/vaccines13090903 · Cited by 3 · see citing works
“According to the 2017 World Health Organization position paper on tetanus vaccination [20], lifelong protection against tetanus typically requires six doses of tetanus toxoid–containing vaccines—three primary doses followed by three booster doses.”
Successful management of neonatal tetanus with autonomic manifestations at a referral hospital in Nigeria: a case report
Onyeje, C. K., & Onyeje, B. T. (2025) · BMC Pediatrics · doi:10.1186/s12887-025-06253-9 · Cited by 3 · see citing works
Neonatal Tetanus Still Exists: A Case Report and Review of Literature
Hajaj, H., Bahari, H., Ayyad, A., et al. (2024) · Cureus · doi:10.7759/cureus.61410 · Cited by 3 · see citing works
“Maternal and NT (MNT) continues to be a leading cause of neonatal mortality, particularly in low-income countries, where case fatality rates range from 80% to 100% [6].”
Background
Generalized Tetanus in A Patient with Infected Sutured Wound: A Case Report
Tejaya, N., & Ramli, M. M. D. R. (2023) · AKSONA · doi:10.20473/aksona.v3i1.37362 · Cited by 3 · see citing works
The Evolving Maternal Vaccine Platform
Adams, R. M., & Gonik, B. (2024) · Reproductive Medicine · doi:10.3390/reprodmed5030014 · Cited by 3 · see citing works
“The WHO recommends one dose of Tdap in the second or third trimester, optimally 15 or more days before the pregnancy ends [47].”
Method
A reduced-dose recombinant pertussis vaccine booster in Thai adolescents: a phase 2/3, observer-blinded, randomised controlled, non-inferiority trial
Puthanakit, T., Tangsathapornpong, A., Anugulruengkitt, S., et al. (2024) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(24)00173-1 · Cited by 3 · see citing works
Safety and immunogenicity of an acellular pertussis vaccine containing genetically detoxified pertussis toxin administered to pregnant women living with and without HIV and their newborns (WoMANPOWER): a randomised controlled trial in Uganda
Nakabembe, E., Greenland, M., Amaral, K., et al. (2024) · The Lancet Global Health · doi:10.1016/s2214-109x(24)00409-1 · Cited by 3 · see citing works
Cost of Delivering Tetanus Toxoid and Tetanus-Diphtheria Vaccination in Vietnam and the Budget Impact of Proposed Changes to the Schedule
Mai, V. Q., Boonstoppel, L., Vaughan, K., et al. (2022) · Global Health Science and Practice · doi:10.9745/ghsp-d-21-00482 · Cited by 2 · see citing works
Routine Vaccination During COVID-19: A Case of Maternal Neonatal Tetanus From Pakistan
Iqbal, S., & Ali, I. (2023) · Frontiers in Reproductive Health · doi:10.3389/frph.2021.790647 · Cited by 2 · see citing works
“Nonetheless, Pakistan is still one among the priority countries which have failed to achieve WHO’s MNT elimination target of neonatal tetanus ( 1 per 1,000 live births per year) in all district of country (4).”
BackgroundInfluential
Acceptance and uptake of vaccines against tetanus, influenza, pertussis, and COVID-19 among pregnant and postpartum women in low- and middle-income countries: a systematic review and meta-analysis protocol
Ayouni, I., Mbangiwa, T., Amponsah‐Dacosta, E., Noll, S. D., Kagina, B. M. N., & Muloiwa, R. (2024) · Systematic Reviews · doi:10.1186/s13643-024-02645-7 · Cited by 3 · see citing works
“The Maternal Neonatal Tetanus Elimination program was the first maternal vaccination initiative to be put into action, and it serves as evidence suggesting the feasibility and potential of vaccination during pregnancy to reduce neonatal mortality, particularly in LMICs [24, 52–54].”
BackgroundResultInfluential
Current Status and Factors of Vaccine Hesitancy in Tetanus Vaccination Among Traumatic Patients - China, 2024.
Chen, X., Zhang, M., Zhao, Y., et al. (2025) · PubMed · doi:10.46234/ccdcw2025.071 · Cited by 2 · see citing works
Effectiveness of Health Education Message in Improving Tetanus Health Literacy among Women of Childbearing Age: A Quasi-Experimental Study
Bukhari, M. H., Ms., K., Mughal, A., et al. (2020) · Journal of Rawalpindi Medical College · doi:10.37939/jrmc.v24i1.1537 · Cited by 2 · see citing works
Do patients with diabetic foot ulcer need booster dose of tetanus vaccine?
Tavassol, Z. H., Sajjadpour, Z., Hasani‐Ranjbar, S., et al. (2022) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-021-00966-1 · Cited by 2 · see citing works
Overuse of tetanus toxoid vaccine: a common but under-addressed issue in Nepal
Shrestha, S., Aryal, R., Yadav, R. S., et al. (2024) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000002525 · Cited by 1 · see citing works
“After receipt of tetanus, diphtheria, and acellular pertussis (Tdap), booster doses of tetanus and diphtheria toxoids (Td) vaccine are recommended every 10 years or when indicated for wound management [5] .”
Background
Global burden, trends, and projections of tetanus for 2050: Based on the 2021 Global Burden of Disease Study
Liu, T., Liu, M., Yang, G., et al. (2026) · Chinese Journal of Traumatology · doi:10.1016/j.cjtee.2026.01.001 · Cited by 1 · see citing works
Tetanus infection in an 11-year-old male with full infant vaccination history: a rare case report
Akello, F., Achen, S., Najjuma, F. V., et al. (2026) · BMC Pediatrics · doi:10.1186/s12887-026-06588-x · Cited by 1 · see citing works
“Both the WHO and the CDC recommend three primary infant doses followed by three booster doses at 12–23 months, 4–7 years, and 9–15 years (WHO), and at 15–18 months, 4–6 years, and 11–12 years (CDC) to ensure lifelong protection, highlighting the importance of boosters beyond infancy [6, 7].”
Two decades of global research on tetanus vaccines and tetanus immunoglobulins: a comprehensive bibliometric analysis and integrative review (2000–2025)
Zhou, C., Zuo, Y., Ma, J., Liang, Z., & Zang, C. (2026) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2026.1766140 · Cited by 1 · see citing works
“…and 42.85, respectively) stem from seminal work on tetanus toxoid immunogenicity (Maple et al., 2000; Bartels et al., 2001; Bröker, 2016), while Switzerland ’ s exceptional average (88.41) arises from WHO-af ﬁ liated studies on global immunoglobulin distribution (World Health Organization, 2018).”
Influential
Population waning trajectories of vaccine-induced tetanus immunity in Zhejiang, China
Chen, F., Zhou, Y., Zhu, Y., Pan, X., Ding, L., He, H., & Qi, X. H. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1824381 · Cited by 1 · see citing works
Human systemic and mucosal immune responses support further exploration of a Klebsiella pneumoniae protein-based vaccine
Campo, J. J., Pearse, O., Zuza, A. M., et al. (2026) · Vaccine · doi:10.1016/j.vaccine.2026.128893 · Cited by 1 · see citing works
CURRENT CONCEPTS IN THE MANAGEMENT OF TETANUS
Tkachenko, Y. A., Shkatula, Y. V., Badion, Y. O., et al. (2020) · Eastern Ukrainian Medical Journal · doi:10.21272/eumj.2020;8(3):242-248 · Cited by 1 · see citing works
Case Report of Neonatal Tetanus
Panna, R. R. K. (2023) · International Journal of Science and Research (IJSR) · doi:10.21275/sr221211090716 · Cited by 1 · see citing works
Adjuvanted Modified Bacterial Antigens for Single-Dose Vaccines
Benedetto, R. D., Massai, L., Wright, M., Mancini, F., Cleveland, M., Rossi, O., Giannelli, C., Scorza, F. B., & Micoli, F. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms252111461 · Cited by 1 · see citing works
From Crisis to Cure: The Resilient Recovery of a Patient With Tetanus
Raman, E., Nallathambi, N., Raghuthaman, G., et al. (2024) · Cureus · doi:10.7759/cureus.75551 · Cited by 1 · see citing works
The Survivor: A Clinical Case of Tetanus in a Non-Immunized, Parenteral Drug User, Former Female Convict with HIV and HCV
Vicente-Alcalde, N., Martín-Casquero, T., Ruescas-Escolano, E., et al. (2020) · Vaccines · doi:10.3390/vaccines8020308 · Cited by 1 · see citing works
Quantitative modeling of the effect of antigen dosage on B-cell affinity distributions in maturating germinal centersPreprint
Molari, M., Eyer, K., Baudry, J., et al. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.05.22.110585 · Cited by 1 · see citing works
An Update on Resurgence of Diphtheria Cases in West Africa: Investigating Factors Behind Outbreaks Despite Annual WHO Vaccination InitiativesPreprint
Tuwleh, L., Hamraa, J., Hassan, A., Emmanuel, A. T., Bropleh, J. T., & Rumide, T. S. (2024) · Preprints.org · doi:10.20944/preprints202408.0814.v1 · Cited by 1 · see citing works
Seroprevalence of antibodies against Diphtheria, Tetanus and Pertussis over a 12-year period in children in Kilifi, Kenya (2009-2021)Preprint
Mburu, C., Ojal, J., Selim, R., et al. (2025) · medRxiv · doi:10.1101/2025.10.07.25337523 · Cited by 1 · see citing works
Measles, Rubella, and Tetanus Vaccinations: a Brief Global Review
García-Mauriño, C., Souverbielle, C. T., & Erdem, G. (2018) · Current Tropical Medicine Reports · doi:10.1007/s40475-018-0143-9
Viruso-bacterial pneumonia, complicated by lightness pulmonary bleeding with death
Chizhova, O. Y., Ruslyakova, I. A., Baculin, I. G., et al. (2020) · Terapevticheskii arkhiv · doi:10.26442/00403660.2020.11.000373
Perfil clínico e epidemiológico dos casos de óbitos por tétano acidental no estado de Minas Gerais, Brasil
Borges, F. V., Silva, B. D. J. E., Pereira, E. H., et al. (2023) · Revista Científica da Escola Estadual de Saúde Pública de Goiás *Cândido Santiago* · doi:10.22491/2447-3405.2023.v9.9h1
KASUS SERIAL: TETANUS GENERALISATA PADA PASIEN USIA LANJUT
Pagehgiri, E. S., Putri, D. K. A., Ekasari, N. W. N., et al. (2024) · Jurnal Medika Malahayati · doi:10.33024/jmm.v8i1.12725
A Preliminary Study to Evaluate the Immune Response to a Booster Dose of the Adult Tetanus-Diphtheria Vaccine (Td) Available in Iran
Noorian, S., Mottaghi-Dastjerdi, N., Soltany‐Rezaee‐Rad, M., Montazeri, H., Baghaei, M., & Niazi, M.-J. (2024) · Iranian journal of pharmaceutical research · doi:10.5812/ijpr-146572
“Additionally, multiple increases in antibody titers from pre-vaccination to post-vaccination were considered seroconversion rates for booster response (12).”
Case report: Plasma exchange treatment in a patient with severe tetanus
Huang, S., Han, F., Zhang, Q., et al. (2024) · Transfusion and Apheresis Science · doi:10.1016/j.transci.2024.104038
Tetanus
Cherry, J. D., & Federman, M. (2025) · Elsevier eBooks · doi:10.1016/b978-0-323-82763-8.00149-7
Reverse and Structural Viral and Bacterial Vaccine Design
Ponnusamy, N., Ravi, N., Palanisamy, T. B., Ahmad, F., & Arumugam, M. (2025) · Springer eBooks · doi:10.1007/978-3-031-77911-4_7
Intrathecal monovalent fragments from two human monoclonal antibodies block tetanus neurotoxin in rodents
Fabris, F., Meglić, P., Šoštarić, P., et al. (2025) · iScience · doi:10.1016/j.isci.2025.113422
Regional distribution of antibiotic resistance in Bacteroides spp. and Clostridium perfringens strains isolated from coloproctological patients in the Russian Federation
Achkasov, S. I., Shelygin, Y. A., Melkumyan, A. R., et al. (2025) · Clinical Microbiology and Antimicrobial Chemotherapy · doi:10.36488/cmac.2025.2.217-228
Progress, challenges and priorities in eliminating maternal and neonatal tetanus in the African region from 2016 to 2024: cross-sectional retrospective analysis
Fouda, A. A. B., Wiysonge, C. S., Yusuf, N., et al. (2025) · Pan African Medical Journal · doi:10.11604/pamj.supp.2025.51.1.47488
Additional file 1 of Comprehensive Health Insurance and access to maternal healthcare services among Peruvian women: a cross-sectional study using the 2021 national demographic survey
Rosas, E. R., Winkler, V. F., Huicho, L., Blas, M. M., Brenner, S., & Allegri, M. D. (2023) · Figshare · doi:10.6084/m9.figshare.24571891
Seroprevalence of antibodies against diphtheria, tetanus, and pertussis over a 12-year period in children in Kilifi, Kenya (2009-2021)
Mburu, C., Ojal, J., Selim, R., et al. (2026) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2026.108396
Antenatal Care and Perinatal Mortality in Low- and Middle-Income Countries: Insights for Maternal and Newborn Health System
Abate, B. J., Abebe, S. A., Alemaw, H. B., et al. (2026) · Mayo Clinic Proceedings Innovations Quality & Outcomes · doi:10.1016/j.mayocpiqo.2026.100697
Perceived safety, effectiveness and acceptability of R21/Matrix-M malaria vaccine among pediatric health practitioners and caregivers in Southeast Nigeria: a cross-sectional studyPreprint
Peter, L. O., Akubue, N. E., & Omotowo, B. I. (2026) · Research Square · doi:10.21203/rs.3.rs-9012196/v1
Determinants of Tetanus Toxoid Vaccination Among Women of Reproductive Age in Somaliland: A Cross‐Sectional Study
Cabdi, M. M., Mohamed, K. H., Yasin, A. M., Nour, A. A., Farah, H. M., Barkhad, L. A., Hassan, K. I., & Hassan, M. S. (2026) · Health Science Reports · doi:10.1002/hsr2.72294
“The World Health Organization (WHO) recommends Tetanus Toxoid (TT) vaccination for all women of reproductive age, particularly during pregnancy, as a cornerstone of its MNT elimination strategy [3].”
Long-term trends in childhood mortality following the expansion of vaccination programs: a 60-year analysis from a university hospital in Rio de Janeiro State, Brazil
Pinheiro, P. Y. M., Vianna, R. A. D. O., Ferreira, L. D. C., et al. (2026) · Acta Tropica · doi:10.1016/j.actatropica.2026.108093
Multi-pathogen serosurveillance reveals correlated routine vaccination performance, waning tetanus immunity, and diphtheria boosting among children in ZambiaPreprint
Sbarra, A. N., Mutembo, S., Carcelen, A. C., Prosperi, C., Moss, W. J., Truelove, S., Winter, A. K., Bwalya, I. C., Betha, E., Kampamba, L., et al. (2026) · medRxiv · doi:10.64898/2026.06.01.26354612
Behavioral heterogeneity in adult tetanus booster vaccination in Chinese adults: identifying a cognitive–behavior gap through latent class analysis
Jiang, W., Li, Y., Guo, Q., et al. (2026) · Vaccine X · doi:10.1016/j.jvacx.2026.100863

Authors: World Health Organization
Corresponding author: World Health Organization
Venue: Vaccine
Publisher: Elsevier BV
Published: 2018-06
Volume: 36
Issue: 25
Pages: 3573-3575
ISSN: 0264-410X (ISSN-L)
DOI: 10.1016/j.vaccine.2017.02.034
OpenAlex: W4210571587
Cited by: 110
References: 4
Citations by year: 2026: 24 · 2025: 12 · 2024: 17 · 2023: 17 · 2022: 9 · 2021: 9 · 2020: 15 · 2019: 6 · 2018: 1
FWCI: 4.63
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Vaccine (publishedVersion)
PubMed (publishedVersion)
Funders: World Health Organization
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Diphtheria, Corynebacterium, and Tetanus
Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
Social Sciences › Health › Vaccine Coverage and Hesitancy
Keywords: tetanus toxoid vaccine, tetanus prevention, booster vaccination, vaccination timing, immunization programs, WHO guidelines
MeSH terms: Adolescent, Adult, Female, Health Policy, Humans, Immunization Schedule, Immunization, Secondary, Infant, Pregnancy, Tetanus, Tetanus Toxoid, Vaccination, World Health Organization, Practice Guidelines as Topic, Immunization Programs

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Tetanus vaccines: WHO position paper, February 2017 – Recommendations

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks