At Mulago hospital’s private wing, I met Janet Kyampaire, an expectant mother of one. Like many of the women waiting in the line, Kyampaire is here to get a tetanus vaccine shot.
She did the same for her first pregnancy, although she says at the time, she missed one of the three recommended shots. Despite taking her tetanus jab religiously now, Kyampaire admits she has no idea why she is being immunised. In fact, she thinks the vaccine is being administered to her because she is pregnant.
According to the World Health Organisation, tetanus is a life-threatening bacterial disease that is caused by the toxin of a bacterium called clostridium tetani. This bacterium enters the body through an open wound such as a tiny prick or scratch on the skin. The infection is more common when there is a deep wound such as a bite, cut, burn or an ulcer.
According to Victoria Nabuule, the nursing officer in charge of immunisation at Mulago hospital, the Tetanus Toxoid (TT) vaccine is administered during pregnancy to prevent a mother and unborn baby from developing the disease.
“When the vaccine is administered, the antibodies formed in the mother’s body are passed on to the baby, giving it protection for least six weeks after birth,” says Nabuule, adding that after six months, the baby should be given its own tetanus shot.
She says: “We give most of the vaccines at six weeks because at that point, the baby is building its own immunity and antibodies. If we give those vaccines before six weeks, a big proportion will not work because the vaccine is destroyed by the antibodies passed on from the mother to the child.”
During a woman’s first pregnancy, at least two doses of the tetanus vaccine are recommended, with the first to be administered as soon as the pregnancy has been confirmed.
Dr Robert Mayanja, the programme manager in charge of the National Expanded Programme on Immunisation (Unepi), says the second dose of the vaccine should be given at least four- to-eight weeks after the first one.
WHO also recommends that a third vaccine be given six months after the second one to provide protection for at least five years.
Unlike other vaccines which give lifelong protection such as DPT, BCG and polio, the tetenus vaccine, according to Nabuule, gives up to 15 years and therefore, booster doses are recommended thereafter.
At Mulago hospital for instance, the immunisation clinic has tetanus doses for adults in five doses, given to people between the ages of 15 and 45.
“Our emphasis is on pregnant women because they are vulnerable to wounds especially during delivery. But other people in reproductive age, including men can take the shot as long as they are at a risk of being injured and are less than 45 years,” Nabuule explains.
According to the Centres for Disease Control and Prevention, vaccines help develop immunity by imitating an infection.
Dr Mayanja explains that when someone is injected with, or swallows a vaccine, their body produces an immune response in the same way it would if exposed to a disease but without the person getting infected from the disease.
“If the person comes in contact with the disease in the future, the body is able to make an immune response fast enough to protect them from getting sick of that particular disease,” he says.
He notes vaccines reduce the risk of infection by working with the body’s natural defence, to help it safely develop a resistance mechanism against particular disease.
A number of immunisations are required and done in the first few years of a child’s life to protect them against many of the serious childhood infections.
“The immune system in young children does not work as well as that of older children and adults. Therefore, more doses of vaccine are needed for younger children,” explains Dr Mayanja.
The first months of life
In the first months of life, a baby is protected from most infections by antibodies from their mothers, which is usually transferred during pregnancy. When these antibodies wear off, the baby is at risk of developing infections and so, the first doses of immunisations should be administered before these antibodies have weakened.