Vaccines for women for preventing neonatal tetanus

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The available evidence supports the implementation of immunisation with tetanus toxoid in communities with similar, or higher, levels of risk of neonatal tetanus. 

Prevention of tetanus in neonates may be possible by the vaccination of pregnant or non-pregnant women, or both, with tetanus toxoid, and the provision of clean delivery services. This review includes three trials that assess the effectiveness of tetanus toxoid, administered to women of reproductive age or pregnant women, to prevent cases of, and deaths from, neonatal tetanus. Two trials assessed the effectiveness of vaccinating women of reproductive age (9823 infants): one (1182 newborns) assessed the effects of tetanus toxoid against polyvalent influenza in preventing tetanus and deaths within the 30th day of life; the other (8641 newborns) assessed the effects of tetanus‐diphtheria toxoid against cholera toxoid administered in women of reproductive age in preventing newborn deaths. The third trial (48 women and their newborns) assessed the safety of tetanus toxoid diphtheria acellular pertussis vaccine (Tdap) administration during pregnancy in comparison with placebo. While the results of the three trials displayed evidence of protective effects against deaths caused by tetanus in newborns, more information is needed on factors that may have a negative impact on the immunisation practice and on the effectiveness of interventions implemented. 

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