<p>A 12-day-old male neonate, born at home during an unattended pregnancy to a multiparous mother who was not immune to tetanus. He was admitted to the pediatric ward of Timbuktu Hospital on March 14, 2022, where the clinical diagnosis of NTD was confirmed by stiff neck, contractures, and inability to suckle. The Td-2 and TdR vaccination coverage rates for women of childbearing age in 2019, 2020, and 2021 were 26.1%; 32.7%; and 33.8%, respectively. Despite intensive care, the subject died on March 19, 2022. The vaccine response resulted in vaccine coverage of 50.53%</p>