2020 Q3 BQ Journal Vol 40 - 23

Morbidity and Mortality Weekly Report

TABLE. Estimated coverage with ≥2 doses of tetanus toxoid-containing vaccine (TTCV) among women of reproductive age (WRA) administered
through routine immunization services, estimated percentage of newborns protected at birth (PAB), number of WRA vaccinated with TTCV
during supplementary immunization activities (SIAs), percentage of deliveries attended by a skilled birth attendant (SBA), and number of
reported neonatal tetanus cases - 59 priority countries, 2000-2018
MNT
elimination
priority
countries

WRA TT2+/Td2+
coverage (%)

Newborns PAB (%)

WRA vaccinated during
TTCV SIAs*

Year†

Year
2000

Year
Change
Change No. of TT2+/
2000-2018
2000-2018 Td2+ doses
2018
(%)
2000 2018
(%)
received

Validated for MNT elimination by end−2018
Bangladesh
89
97
9
89
Benin
81
69
−15
87
Burkina Faso
NA
92
NA
57
Burma
81
89
10
79
Burundi
28
90
221
51
Cambodia
40
75
88
58
Cameroon
40
66
65
54
China
NA
NA
NA
NA
Comoros
40
78
95
57
Congo
39
83
113
67
Côte d'Ivoire
78
85
9
76
Egypt
71
NA
NA
80
Equatorial
30
41
37
61
Guinea
Eritrea
25
65
160
80
Ethiopia
32
87
172
54
Gabon
16
50
213
39
Ghana
73
64
−12
69
Guinea Bissau NA
NA
NA
49
Haiti
NA
NA
NA
41
India
80
81
1
85
Indonesia
81
47
−42
82
Iraq
55
49
−11
75
Kenya
51
61
20
68
Laos
45
37
−18
58
Liberia
25
74
196
51
28
58
Madagascar
40
51
Malawi
61
67
10
84
Mauritania
NA
31
NA
44
Mozambique
61
85
39
75
Namibia
60
76
27
74
Nepal
60
75
25
67
Niger
31
94
203
63
Philippines
58
48
−17
55
Rwanda
NA
90
NA
81
Senegal
45
65
44
62
Sierra Leone
20
90
350
53
South Africa
65
NA
NA
68
Tanzania
77
94
22
79
Timor-Leste
NA
68
NA
NA
Togo
47
76
62
63
Turkey
36
55
53
50
Uganda
42
66
57
70
Vietnam
90
88
−2
86
Zambia
61
76
25
78
Zimbabwe
60
75
25
76

SBA attendance at
delivery (%)

%
vaccinated

2000

No. of neonatal tetanus cases
Year

Change
2000-2018
(%)
2018

2000

2018

Change
2000-2018
(%)

98
85
92
90
90
93
85
NA
85
85
85
86
70

10
−2
61
14
76
60
57
NA
49
27
12
7
15

1,438,374
1,399,461
2,306,835
8,170,763
679,222
2,099,471
2,687,461
NA
160,767
273,003
5,924,527
2,518,802
26,466

47
97
91
87
55
79
85
NA
55
91
85
87
9

12
66
38
57
25
32
56
97
62
83
63
61
65

68
78
80
60
85
89
65
100
NA
91
74
92
NA

467
18
111
5
240
178
16
3
NA
10
17
51
NA

376
52
22
41
16
295
279
3230
NA
2
30
321
NA

84
13
3
22
0
14
27
83
1
0
17
2
6

−78
−75
−86
−46
−100
−95
−90
−97
NA
−100
−43
−99
NA

99
93
85
89
83
81
90
85
75
88
90
89
78
89
80
86
88
89
81
90
95
95
90
90
90
83
83
95
85
94
85
87

24
72
118
29
69
98
6
4
0
29
55
75
34
6
82
15
19
33
29
64
17
53
70
32
14
NA
32
90
21
9
9
14

NA
13,210,107
79,343
1,666,666
312,669
2,785,588
7,643,440
1,442,264
111,721
4,463,695
968,323
288,984
2,705,588
NA
586,277
605,640
NA
4,537,864
2,184,277
1,034,080
NA
359,845
1,704,814
NA
987,575
24,141
262,130
1,242,674
2,448,527
367,842
330,030
NA

NA
84
90
87
98
88
94
50
96
67
90
57
72
NA
76
79
NA
86
92
78
NA
92
102
NA
71
53
87
58
86
69
81
NA

28
6
86
47
32
24
43
66
65
42
17
51
47
56
53
48
76
12
16
58
31
58
37
91
43
18
35
83
39
59
42
NA

NA
16
NA
78
45
42
81
94
96
62
64
61
44
87
69
73
88
58
40
84
91
68
69
97
64
57
45
98
74
94
63
78

NA
167
NA
66
41
75
88
42
48
48
276
20
−6
55
30
52
16
383
150
45
194
17
86
7
49
217
29
18
90
59
50
NA

4
20
8
80
NA
40
3287
466
37
1278
21
152
13
12
NA
42
10
134
55
281
5
0
36
11
48
NA
33
26
470
142
130
16

0
14
0
9
0
3
129
14
3
NA
16
14
30
9
0
160
0
2
9
54
2
6
36
0
0
1
14
0
78
37
71
0

−100
−30
−100
−89
NA
−93
−96
−97
−92
NA
−24
−91
131
−25
NA
281
−100
−99
−84
−81
−60
NA
0
−100
−100
NA
−58
−100
−83
−74
−45
−100

See table footnotes on the next page.

targeted 201 million women of reproductive age received at
least 2 doses of TTCV (4). In 2018, 49 million women remain
unreached by TTCV SIAs (Figure 1). Among the 52 countries
that conducted TTCV SIAs, 29 (56%) vaccinated ≥80% of
the targeted women with ≥2 doses of TTCV (Table). Among
the 45 countries that achieved MNT elimination by the end of

516

MMWR / May 1, 2020 / Vol. 69 / No. 17

2018, 38 (84%) had conducted TTCV SIAs. Among the seven
countries that achieved elimination by the end of 2018 but
did not conduct SIAs, six (China, Eritrea, Namibia, Rwanda,
South Africa, and Zimbabwe) achieved MNT elimination
through strengthening of routine immunization and reproductive health services; one country (Malawi) achieved elimination

US Department of Health and Human Services/Centers for Disease Control and Prevention

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2020 Q3 BQ Journal Vol 40

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