Knowledge, Awareness, and Uptake of Tetanus Vaccination Among Women of Childbearing Age (15-49 Years) in Nguru Local Government, Yobe State, Nigeria

Background and Objective: Maternal and neonatal tetanus (MNT) remain preventable yet persistent causes of morbidity and mortality in low-resource settings. This study evaluated knowledge, perceptions, and uptake of tetanus toxoid (TT) vaccination among women of reproductive age (15-49 years) in Nguru Local Government Area, Yobe State, Nigeria. Materials and Methods: A community-based cross-sectional study was conducted from April to August 2023. A stratified random sample of 250 women across ten administrative wards completed a validated interviewer-administered questionnaire adapted from WHO KAP tools. Data on socio-demographics, awareness of tetanus and vaccination schedules, perceived barriers, and self-reported vaccination history were collected. Perceptions were ranked using the Relative Importance Index (RII), and analyses included descriptive statistics, chi-square tests, and multivariable logistic regression to identify predictors of vaccine uptake. Results: The mean age of respondents was 29.8±8.7 years; most were Muslim (90.4%) and married (69.6%). Awareness of tetanus vaccination was low (25.6%), with 51.2% believing it was needed only after injury. Misconceptions were widespread, notably the belief that TT vaccination reduces fertility, which, along with fear of injections, ranked highest as perceived barriers (RII = 0.707). Uptake was insufficient: 74.8% had received no TT doses, 19.2% were partially vaccinated (1-4 doses), and only 6.0% completed the five-dose schedule. Multivariable analysis identified parity (≥5 children) and previous pregnancy as significant positive predictors, whereas lower education and single marital status were associated with lower uptake. Conclusion: Knowledge and coverage of TT vaccination in Nguru are critically low, driven by misinformation, fear, and limited continuity of care. Programmatic interventions should combine culturally tailored community engagement, male and religious leader involvement, school-based vaccination for adolescents, strengthened antenatal counseling, and simple local registries to improve follow-up. Targeted strategies are essential to close immunity gaps and reduce the risk of maternal and neonatal tetanus.