Baby vaccinations in SA: what and why
Everything you need to know about vaccinations and childhood diseases.
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Updated: 23 November 2017

Also see: The vaccination schedules in South Africa: is your child up to date?

The vaccinations explained

BCG: fights Tuberculosis

Named after Bacille Calmette-Guerin, this vaccine to fight TB is required in South Africa at birth and will automatically be given to your baby in the hospital. It is a freeze-dried vaccine prepared from an attenuated strain of bovine tuberculosis. If no scar is visible at three months, then the vaccine is repeated. South Africa still has a high rate of TB infection, in spite of this vaccination, but it seems to protect children against TB meningitis and milliary (widely disseminated) TB, both potentially fatal.

DTaP vaccine

  • Diphtheria (a severe respiratory infection) can be fatal as the infected membrane in the throat swells up and can cause suffocation, and the toxin may cause damage to the heart and brain. Epidemics used to be associated with a high mortality rate, but according to the South African Vaccination and Immunisation Centre (SAIVC), during the last 5 years, less than 10 cases of diphtheria have been reported in South Africa, as a result of high vaccination coverage.
  • Tetanus (lockjaw) can be contracted from deep, dirty wounds. It’s often fatal and characterised by muscular spasms. The disease is caused by Clostridium tetani bacteria that usually enter the body through an open wound, or a newborn’s umbilical cord. The SAIVC states: “According to the WHO, South Africa, Namibia, Tanzania and Zimbabwe have potentially eliminated maternal and neonatal tetanus.”
  • Pertussis (whooping cough) is highly contagious and is spread through contact with an infected person. Most cases, and the majority of fatalities, are observed in infancy, especially under one year.

Different combinations are available:

  • DTaP-IPV//Hib (pentavalent, or the 5-in-1 vaccine);
  • DTaP-IPV-Hib-HBV (hexavalent, or the 6-in-1);
  • DT (diphtheria and tetanus);
  • Td (tetanus and reduced amount of diphtheria vaccine);
  • TdaP-IPV (tetanus and reduced amount of diphtheria vaccine with acellular pertussis and inactivated polio vaccine).

Hib: fights haemophilus influenza type B disease

Since 1999 South African babies are given three vaccinations against haemophilia influenza type b (Hib) bacteria, which are given in a combined vaccine with DTP. Most of us have this bacterium in their bodies, but it doesn’t normally cause disease in people with normal immune systems. Small children who are not immunised are in danger of developing the disease, which can cause bacterial meningitis and pneumonia, both of which is life threatening. The greatest risk is in babies between the ages of 4 and 12 months. 

Hepatitis A (optional)

Hepatitis A is a viral infection of the liver caused by food poisoning and usually gets transmitted at restaurants. It’s usually a very mild disease in children, but it can result in severe illness for the adults who are exposed to the infected child.

Dr Sears adds, “This food-poisoning illness usually gets transmitted at restaurants. It’s a very mild disease in children. It isn’t fatal and doesn’t cause long-term complications.” Outbreaks of hepatitis A occur almost every year in South Africa.

Hep A vaccines are not licensed for use in children younger than 1. In South Africa, Avaxim 80 is commonly used. Recently, a combination Hep A and Hep B vaccine, called Twinrix, was made available. It’s given in three doses, using a 0-, 1-, and 6-month schedule.

Dosage: A primary dose of the vaccine can be given to children over age 1. This is followed by a booster dose 6 to 18 months later.

Hepatitis B

Hepatitis B is a serious viral infection of the liver and is very common in South Africa. It can be transmitted through child-to-child contact, most probably through weeping sores, cuts, bites, scrapes and scratches. 

Gardasil/Cervarix: fights HPV

The Human Papillomavirus can cause cervical and penile cancer and genital warts, although for most women and girls the virus goes away on its own if their immune systems are strong. HPV is not only transmitted sexually and has been found quite frequently in young women without prior experience of sexual intercourse. Getting vaccinated can help protect against HPV and its consequences. Women from the age of 9 to 45 can be vaccinated with the bivalent HPV vaccine. Boys from the age of 9 to 17 can be vaccinated with the quadrivalent HPV vaccine. 

OPV/IPV: Polio

Polio is a potentially devastating disease, and although the last confirmed case of polio in South Africa was in 1989, it is still endemic in Africa the threat of imported polio remains a possibility. At its worst it results in paralysis, and even people now in middle age may have had friends at school who used calipers on their legs as a result of childhood polio infection leaving them with weak, damaged muscles. The oral polio vaccine (OPV) is given by mouth at birth and again at 6 weeks, and contains a weakened version of the polio virus. The inactivated polio vaccine (IPV) is included in the pentavalent or hexavalent shot.

Measles vaccine

Measles is a highly contagious – but rare – viral respiratory infection common in children between 3 and 10 years of age. It causes a total-body skin rash and flu-like symptoms, including a fever, aches, cough and runny nose. Most kids will work through the illness without much trouble but there can be complications such as pneumonia (in about 1 in 100 cases) or the more severe encephalitis (infection within the brain), which occurs in about 1 in 1,000 cases. The fatality rate from measles is high at about 1 in 2,000 cases.

Rouvax or Measbio is generally used to vaccinate kids against measles, unless the private MMR option is used.

MMR vaccine: fights measles, mumps and rubella (optional)

  • Measles (see above). 
  • Mumps is a contagious viral infection that targets the salivary glands, causing swollen tonsils and facial glands, fever and rash, but most children get through it without much trouble although there could be serious complications. 
  • Rubella (German measles) is common in children between the ages of 3 and 10 years. Dr Sears says, “Rubella is harmless to any child or adult who catches it but if a pregnant mom catches rubella it can cause birth defects.” The SAIVC states that in South Africa there were 117 reported cases in 2007.

MCV: fights meningococcal disease (optional)

The meningococcal conjugate vaccine protects against a very aggressive form of meningitis that is often deadly before it has even been diagnosed. It can be given in addition to the PCV. 

OPV/IPV: fights polio

Polio is a potentially devastating disease, and although the last confirmed case of polio in South Africa was in 1989, it is still endemic in Africa the threat of imported polio remains a possibility. At its worst it results in paralysis, and even people now in middle age may have had friends at school who used calipers on their legs as a result of childhood polio infection leaving them with weak, damaged muscles. The oral polio vaccine (OPV) is given by mouth at birth and again at 6 weeks, and contains a weakened version of the polio virus. The inactivated polio vaccine (IPV) is included in the pentavalent or hexavalent shot.

PCV: fights pneumococcal diseases

The pneumococcal conjucated vaccine, like Prevenar and Synflorix, protects against bacterial pneumococcal diseases, such as streptococcus pneumonia which can cause infant and toddler meningitis, pneumonia, blood infections and middle-ear infections

The SAIVC states that there is a lack of information about the risk in developing countries, although globally, from an estimated annual 1,609,000 fatalities, 841,000 occur in children under the age of 5, according to the WHO.

All infants and children between the ages of 6 weeks and 9 years can be vaccinated with the Prevenar vaccine against this bacterial form of pneumonia. 

Dosage: Children under 15 months receive 4 doses. The first may be given at 6 to 8 weeks, with intervals of 4 to 8 weeks between doses. Older children or late starters receive 2 doses one month apart, followed by a booster dose after the first birthday.

Rotarix: fights the rotavirus

The Rotavirus vaccine Rotarix is an oral liquid that will protect your child from the most severe forms of gastroenteritis, which causes vomiting and diarrhoea. It is very common and can quickly dehydrate an infant, which can be fatal. Rotarix can be given from 6 weeks and should be given before 6 months of age.

Varilrix: fights chickenpox (optional)

The Varilrix vaccine protects a child against the varicella virus that causes chickenpox, and also reduces the risk of developing shingles as an adult. Chicken pox is an uncomfortable infection that forms non-painful blisters all over the body, which scab over in a few days and cause severe itching. It can lead to scarring and in some (rare) cases complications such as pneumonia and death.

The SAIVC states there is little information regarding the risk of chickenpox in South Africa. Dr Sears says, “The fatality rate from this disease is very low – about 1 in 65,000 cases”.

The Varilrix vaccine against chickenpox is a live vaccine, regarded as being around 95% effective. It will also prevent your child contracting shingles in later life.

Dosage: from 9 months to (and including) 12 years, 1 dose. From 13 years and older, two doses with at least six weeks between them.


Top 5 truths about MMR

  1. MMR immunisation is the safest way to protect children against measles, mumps and rubella.
  2. Over 500 million doses of MMR have been used in 90 countries around the world since the 1970s. According to The World Health Organization, MMR is a highly effective vaccine with an outstanding safety record.
  3. No country in the world recommends giving MMR vaccine as three separate injections.
  4. Children who are not immunised with MMR increase the chance that others will get the diseases.
  5. Evidence proves that MMR vaccine does not cause autism or inflammatory bowel disease (IBD). There are now numerous studies that do not support a link between autism and IBD and the MMR vaccine.

Read more:

The vaccination schedules in South Africa: is your child up to date?

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