Immunizations are a very important part of a child’s routine care. Immunizations have greatly reduced vaccine preventable illnesses and death. Immunizations are done at healthy baby clinics and not at the practice. Stork’s Nest is the healthy baby clinic at Netcare Pta East hospital, but you are also welcome to have the immunizations done at a pharmacy clinic or a private sister running a healthy baby clinic. Be sure to discuss all questions and concerns regarding immunization during your child’s routine visits.
Vaccination time table

Below is an example of a widely accepted immunization schedule for South Africa. This may differ, depending on whether you choose the state-subsidized schedule or the private schedule. Nurses that run well baby clinics may sometimes follow a schedule that is slightly different from this one. 

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Vaccines explained

OPV: Oral polio vaccine. This vaccine is still part of the national vaccination schedule for South Africa (EPI = Extended program of immunization).The trivalent vaccine was replaced by the bivalent vaccine in April 2016, with the aim of stopping OPV in 2019-2020.

 

BCG: This is a vaccine against tuberculosis. Although it is not 100% effective, it protects against the serious form of tuberculosis that is called tuberculous meningitis. It is recommend in countries where Tuberculosis is still endemic. It is normally given at birth, but can be given up to the age of 1 year.

HepB: Hepatitis B vaccine. In South Africa, this vaccine is given at 6-8 weeks, 10-12 weeks, 14-16 weeks and a booster at 18 months. It is often part of a 6-in-1 vaccine. If the mom is known to have Hepatitis B, the HepB vaccine, as well as HepB immunoglobulin is given already at birth.

DTaP: This acronym stands for Diphtheria, Tetanus and acellular Pertussis vaccine. It is given at 6-8 weeks, 10-12 weeks, 14-16 weeks and a booster at 18 months. It is normally part of a 5-in-1 or 6-in-1 vaccine. Only given up to the age of 7 years.

IPV: This is the injectable polio vaccine. It is given at 6-8 weeks, 10-12 weeks, 14-16 weeks and a booster at 18 months. It is normally part of a 5-in-1 or 6-in-1 vaccine.

Hib: The H. Influenza vaccine is given at 6-8 weeks, 10-12 weeks, 14-16 weeks and a booster at 18 months. It is normally part of a 5-in-1 or 6-in-1 vaccine.

RV: This is the rotaviral vaccine. If the monovalent rotaviral vaccine is given, 2 doses are given at 6 and 14 weeks. If the pentavalent vaccine is given, 3 doses are given at 6, 10 and 14 weeks.

PCV13: The pneumococcal conjugate vaccine protects against pneumonia, ear infections, meningitis and septicemia. Four doses are needed for optimal protection.

PPSV23: The pneumococcal polysaccharide vaccine is given from the age of 2 years for high risk children, eg. Children with cancer, immunosuppression, after splenectomy, etc.

Measles: Measles is still endemic in South Africa. Because it has such a high morbidity and mortality in infants younger than 1 year, it is already given at 6 months and then again at 12 months as Measbio.  Alternatively, it can be given as part of the MMR at 12 months and at 6 years.

HAV: The Hepatitis A vaccine is not part of the EPI, but is given at 12 and 18 months on the private schedule.

VAR: This vaccine provides protection against chickenpox. Not only can chickenpox have devastating cosmetic consequences, but could also lead to serious complications and even death. It is not part of the EDI, but on the private schedule it can be given from the age of 9 months. Two doses are needed for optimal protection.

MMR: This is probably the most well known vaccine, unfortunately for all the wrong reasons. In 1998, a former British surgeon and medical researcher published a paper in the Lancet medical journal stating that there is a link between the MMR vaccine and autism. This caused thousands of parents to refuse MMR vaccination for their children. After an investigation in 2010 by the General Medical Council, the Lancet fully retracted the article. Wakefield was struck from the role and is not allowed to practice medicine anymore. This has unfortunately led to many measles epidemics and thousands of deaths. MMR is given at 15 months.

TdaP: This is the combination of the Tetanus and and a reduced amount of diphtheria vaccine. It is given from the age of 7 years.

HPV: This vaccine protects against human pappiloma virus infection, which is linked to cervical cancer. The quadrivalent vaccine can be given to boys and girls, the bivalent vaccine is given to girls only. Three doses are needed. It can be given from the age of 9 years. It is not fully part of the EDI yet. Some schools have been chosen where girls from the age of 9 are vaccinated against HPV.

Meningococcal vaccine: This is a vaccine that protects against one of the most feared diseases. The meningococcal organism can either cause a blood infection or meningitis and has a very high mortality. There are, however different strains of the organism that can cause disease. These strains differ from country to country and even within a country. The vaccine protects against four strains of the organism. Vaccinating your child against meningococcal disease is thus not a guarantee that your child will not develop meningococcal disease.

Influenza:  The WHO recommends yearly flu vaccinations for everyone from the age of 6 months.  The best time to do it is in autumn (March/April in South Africa).  In children who receive their first ever flu vaccination below the age of 8 years, 2 doses are given 4 weeks apart.

Vaccine trade names
Vaccine Trade name Age group
BCG BCG Birth up to 1 year
Chickenpox Varilrix®/ Onvara® 9 months and older
DTaP-IPV/Hib/HBV Infanrix-Hexa® 8 weeks to 2 years
DTaP-IPV/Hib Pentaxim® 6 weeks to 2 years
Hepatitis A Avacim 80® / Havrix junior® 1-15 years
Hepatitis B Heberbiovac HB® / Euvax® / Energix-B® Birth to adulthood
HPV Gardasil® (quadrivalent) 9-26 years
Cervarix® (bivalent) 9 years and older
Influenza Vaxigrip® Yearly from 6 months
Influvac® Yearly from 6 months
Measles Measbio® 6 Months and 12 months
Meningococcal vaccine Menactra® From 9 months
Mencevax® / Menomune® From 2 years
MMR Trimovax® / Priorix®/ Omzyta® 1 year to adulthood
MMRV Priorix Tetra® 9 months to 12 years
OPV OPV-Merieux® / Polioral® Birth to adulthood
PCV Prevenar-13® 6 weeks to 5 years
PCV/NTHi Synflorix® 6 weeks to 5 years
PPSV23 Pneumovax® Imovax® Pneumo23® From the age of 2 years in selected patients
RV Rotarix® 1st dose from 6 weeks, 2nd dose before 24 weeks
Rotateq® 1st dose from 6 weeks, 3rd dose before 32 weeks
TdaP-IPV Adacel-Quadra® From 3 years
Boostrix Tetra® From 4 years
Td Diftavax® From 6 years
Common reasons for missed opportunities

There are often misperceptions about reasons a child should not be vaccinated. This leads to missed opportunities which could be detrimental to the child’s health. The following are NOT reasons for your child to miss an immunization:

 

  • Mild acute illness with/without fever (Common cold, gastroenteritis, ear infection, etc)
  • Recovering from an acute illness
  • Mild to moderate redness, swelling or soreness after previous dose
  • Mild to moderate fever after previous dose
  • Current antibiotic use (except for typhoid vaccination – which is rarely given in South Africa)
  • Premature babies
  • Recent exposure to infective diseases
  • History of penicillin allergy or other non-vaccine allergies
  • Egg allergy*

* Egg allergy is not a contraindication for measles vaccination. Influenza vaccine, though, is cultured on egg embryos. Children who are PROVEN to be egg allergic, should receive their influenza vaccine in a hospital based clinic.

Contraindications to vaccination

Contraindications include, but are not restricted to…

  • A true allergy to one of the vaccine components, eg Neomycin, Streptomycin
  • Administration of human immune globulin in the previous month, eg Beriglobin injection
  • Live, attenuated vaccines (OPV, BCG, MMR) may not be given in immunodeficient patients or if there are immunodeficient household contacts.
  • Note the age limit of certain vaccines