The Expanded Programme on Immunisation in South Africa (EPI-SA)

Vaccinating against diseases like measles, rubella, polio, diphtheria, whooping cough (pertussis), tetanus, hepatitis B, Haemophilus influenzae type b (Hib), tuberculosis, pneumococcal disease and diarrhoea caused by rotavirus, is a free public health service available in Public Clinics in South Africa^5,8. The main target population for the EPI-SA are pregnant women and children under 13 years old⁵.

To help protect you and your child, we have provided a brief overview of the vaccinations available from pregnancy to early adolescence, based on the EPI-SA national recommendations for 2024.

Vaccination in Pregnancy:

As an expecting mother, you will be given a dose of the tetanus, diphtheria, and pertussis vaccination during your 2^nd to 3^rd trimester of your pregnancy (between 26 weeks and 34 weeks)^5,9. A baby gets disease immunity (protection) from their mother during pregnancy¹⁰. This immunity can protect baby from some diseases during the first few months of life¹⁰. Immunity in newborn babies is only temporary and starts to decrease after the first few weeks or months⁴. As newborn immunity is only temporary, it's important to begin childhood vaccinations when your baby is 6 weeks old^4,5.

Infancy to toddler age:

New to the world and at this stage, your child’s immune defences are still learning what it means to live in a world full of strange, new bacteria and germs. Your child needs to be vaccinated from birth against tuberculosis and polio, with a booster for the oral polio vaccine given when they are 6 weeks old⁵. From 6 weeks, your child needs to be vaccinated to protect them against rotavirus, diphtheria, tetanus, pertussis (whooping cough), hepatitis B, polio, Haemophilus influenzae type b infections, and return for boosters at 10 weeks, 14 weeks, and 18 months⁵. For protection against pneumonia, the pneumococcal vaccine is given from 6 weeks, with two boosters needed at 14 weeks and 9 months⁵.

Other vaccinations to keep in mind during the infancy stage include the measles and rubella vaccine and a booster at 6 and 12 months⁵. Seasonal vaccines like the flu vaccine, come into play from around 6 months of age¹¹.

Childhood to adolescence:

When your child begins their school chapter of life, it introduces a whole new world of cross-contamination possibilities. By school entry age (6 years old) your child will get their first dose of a vaccine that helps protect against diphtheria, tetanus, and acellular pertussis⁵.

In grade 5 of their school year, girls can receive the human papillomavirus (HPV-2) vaccine, to receive protection against the human papillomavirus, which in some cases can cause cancer^5,12.

As your child bids goodbye to his or her early adolescent years by the age of 12, it’s time for follow-up vaccinations for protection against tetanus, diphtheria and whooping cough, following primary immunisation⁵. For a missed dose of this vaccine, a ‘catch-up or campaign’ dose is offered during grade 5 for both girls and boys⁵. A booster vaccine for these 3 diseases is recommended every 10 years¹³.