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  1. Dr. Chandralal Mongar
  2. Vaccines and delivery technologies
  3. Wednesday, 27 February 2019

Dear TechNet members,

Bhutan is using Tetanus-Diphtheria (Td) during pregnancy. Guidelines provide clear instruction for women who have no record of previous Td vaccination and those who have received 3, 4 and 5 previous doses of Td containing vaccine. However, I could not find how many doses of Td should be given to pregnant women who has already received 1 or 2 doses of Td containing vaccine in the past.

Appreciate your expert advice please. 

Thank you. 


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In India recently Td has been introduce in Immunisation system. The guideline is same as TT. In Pregnant woman it should be given 2 doses, first dose as early as possible after confirmation of pregnancy and 2nd dose after 4 weeks. In subsequent pregnancy it should be one booster dose, if the lady taken 2 doses earlier within last three years and there is documentary proof ( like Immunisation card) . In case of doubt , the lady should be given 2 doses in subsequent pregnancy
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Robert Steinglass Accepted Answer
It would be good to hear from your WHO or UNICEF advisor in Thimphu or at the regional office.  My view is that she would need just a single dose of Td.

Robert Steinglass
former JSI (semi-retired)
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