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This message has been cross-posted from HPV Vaccine Global Community of Practice. With many thanks to Robert Steinglass.

Dear Lisa,

I agree with Sarah Mullins that there is a great opportunity to find links with a larger package of interventions, including tetanus vaccination. The following four resources provide some relevant background information.

a) To read about school-based immunization experiences, much of which has been based on administration of tetanus toxoid, documented from Indonesia, Malaysia, Sri Lanka and Tunisia, readers may be interested in visiting the WHO web site at:

b) Hard to locate information from a slide presentation from 2009 on the “Potential Role of School-Based Immunization in Protecting More Children: Results of an e-mail survey” is attached. Again much of the experience is based on administration of tetanus toxoid.

c) Experience in immunizing school-age children and adolescents is summarized in Vaccine 28(5):1138-47 (2009).
Immunizing school-age children and adolescents: Experience from low- and middle-income countries.
Maria Sophia Mackroth, Kathleen Irwin, Jos Vandelaer, Joachim Hombach and Linda O Eckert

d) The following excerpt from a BASICS monograph on sustaining neonatal
tetanus elimination (available under the maternal and neonatal tetanus which is available athttp:// --
before the advent of HPV vaccine -- might be of some interest: "To sustain the progress made by immunizing both childbearing-age women in high-risk areas and infants, many countries should consider adopting a supplementary population-based approach to immunizations, such as school-age boosters. School-based immunizations are an investment in today’s children that will produce future benefits when these children become parents. In countries with a high female primary school enrollment, school immunizations may be a cost-effective investment for tetanus prevention, especially if they are part of an integrated primary health care strategy that includes health education and the simultaneous administration of anthelmintics, screening and treatment for trachoma, treatment for lymphatic filariasis, group A meningococcal meningitis immunization, typhoid immunization, and others." Source: Steinglass, Robert. 1998. "Using Early Childhood Booster Doses to Maintain the Elimination of Neonatal Tetanus." Based on a paper delivered at the World Health Organization (WHO) Neonatal Tetanus Elimination Technical Consultation, Geneva, 1997. Published for the U.S. Agency for International Development (USAID) by the Basic Support for Institutionalizing Child Survival (BASICS) Project. Arlington, Va.:


Attachment: school tetanus GIM09 - Session 1 - J Vandelaer.ppt

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