advertisement
Updated 13 February 2013

Vaccinations during childhood

There are many ways to protect your child, but when it comes to protection against certain childhood diseases, we strongly recommend vaccination.

3

Summary

There are many ways to protect your child against childhood diseases as they grow up, but when it comes to protection against certain childhood diseases, we strongly recommend vaccination.

It is therefore very important that children are vaccinated against these dangerous and preventable diseases. The vaccines on the EPI programme are provided free of charge by the South African Government at government and municipal clinics. Private clinics (such as clinics in pharmacies) and private nurses and doctors also provide these vaccines for free, but require a consultation fee; this usually includes a counselling session that monitors, among other things, the growth and development of the baby.

 In South Africa, vaccines are available to prevent the following common childhood diseases:

  • Tuberculosis                                          
  • Poliomyelitis                                            
  • Diphtheria                                               
  • Hepatitis A and B                                   
  • Mumps                                                    
  • Varicella (Chickenpox)                           
  • Rotavirus (Gastro)                 
  • Pneumococcal infection (meningitis, infection of the lung, blood infections and infection of the middle ear)
  • Tetanus
  • Pertussis (Whooping Cough)
  • Haemophilus Influenzae type B (Hib)
  • Measles
  • Rubella (German measles)
  • Influenza (Flu)

How is a vaccine made?

Most vaccines contain purified fragments, taken from dead bacteria or viruses (germs). Some vaccines contain live viruses, but in a very weak form that will not bring about the disease.

How do vaccines work?

Vaccines “teach” the immune system how to recognize and fight certain germs, bacteria and viruses before a particular disease can gain a foothold. By giving the body a small “sample” of the germ, it can develop resistance, without actually contracting the disease.

Why give babies and children vaccines?

Certain vaccine-preventable diseases can infect babies within the first few months of life. Vaccinating these babies helps provide them with protection when it is needed. Some of these immunisations have to be repeated to make sure the baby/child remains protected.

The safety of vaccines

In the last decade, numerous changes in vaccine production and administration have reduced the number of side-effects and resulted in safer vaccines. This process never stops, and research continues to develop improved vaccines.

Side effects of vaccines

The different vaccinations’ side effects will be discussed with each vaccine. The most typical side-effects include a slight fever, drowsiness and soreness at the injection site. Although extremely rare, vaccines can cause other side-effects, e.g. very high temperatures. If your child develops a highfever (more than 39º C), or appears to be in severe pain, seek medical attention immediately.

The flu injection

A paediatric (child) flu vaccine is available. This is not part of the EPI immunization programme in South Africa. There are lots of different opinions about giving it to children under the age of 6 months. Discuss this with your healthcare provider.

The road to health chart

If you gave birth in a hospital maternity ward, you will be given a “road to heath” chart. These charts don't all look the same, as each hospital and the state have their own. Make sure you receive a chart before leaving the hospital. If the baby was born at home, you can get a chart from your nearest clinic. Make sure you take the baby’s birth certificate with you.

All the details about your  baby’s health will be entered on the chart by the doctor or clinic sister. Vaccination information also has to be filled in on the chart. Remember to keep the chart in a safe place, because you will need it when your child goes to school. Always take it with you to the clinic, doctor or hospital; most clinics will not immunize your child without it.

National routine immunisation schedule

Age of child Which vaccine? How and where is it given?
At birth

BCG (vaccine against TB)

Polio vaccine

vaccination in upper right arm

drops by mouth

6 weeks old

Polio vaccine

DTP* vaccine

Hib*** vaccine

Hepatitis B vaccine

drops by mouth

injection in left thigh

injection in left thigh

injection in right thigh

10 weeks old

Polio vaccine

DTP* vaccine

Hib*** vaccine

Hepatitis B vaccine

drops by mouth

injection in left thigh

injection in left thigh

injection in right thigh

14 weeks old

Polio vaccine

DTP* vaccine

Hib*** vaccine

Hepatitis B vaccine

drops by mouth

injection in left thigh

injection in left thigh

injection in right thigh

9 months old Measles vaccine injection in right thigh
18 months old

Polio vaccine

DTP* vaccine

Measles vaccine

drops by mouth

injection in left arm

injection in right arm

6 years old

Polio vaccine

Td** vaccine

drops by mouth

injection in left arm

DTP* = vaccine against diptheria, whooping cough and tetanus (lock-jaw)

Td** = vaccine against diphteria and tetanus only

Hib*** = vaccine against Haemophilus influenzae type b

All the above vaccines are freely available at state and private clinics. (You only pay for the “well baby consultation”, as mentioned.)

Discussion of the EPI immunisation vaccines

 

OPV-Merieux Polio vaccine protects against the following: Poliomyelitis

  • Used exclusively via the oral route: 2 drops, which, with the aid of a dropper, provided with the vaccine, can be administered directly into the mouth.
  • First dosage at birth, then at six weeks, and a booster at 6 years

Side effects

  • Rigors (shivering) 
  • Asthenia (weakness)
  • Myalgia (pain in the muscles)
  • Arthralgia (severe pain in joints)

When to be worried

  • Inconsolable crying
  • Muscle weakness

When to take baby to doctor or casualty ward

  • Persistent, inconsolable crying

Vaccination should be postponed in case of

  • Acute illness
  • Within 3 months of prior administration of immunoglobulins

Treatment

  • People in contact with recently immunized babies should be advised of the need for strict personal hygiene, particularly hand washing after nappy changes for 3-4 days after vaccination.
  • Put soiled nappies in a plastic bag before discarding for 3-4 days after vaccination. 

 

BCG vaccine SSI Tuberculosis vaccine protects against the following: Tuberculosis

  • Babies should be immunised as soon as possible after birth.
  • Children under 1 should receive 0.05 ml of the reconstituted vaccine intradermally.
  • Children older than 1 year should receive 0.1 ml.
  • The injection is to be given slowly, strictly intradermally, into the upper layer of skin of the right arm in the region over the distal insertion of the deltoid muscle.

Side effects

  • Small, red area after 3 weeks
  • Small papule, with scaling and scabbing, after 6 weeks
  • Formation of a small vesicle
  • Ulcer, 2-4 weeks after vaccination
  • Healing taking from 2-5 months.
  • Small flat scar forming after 1 year

When to be worried

  • Enlargement of auxiliary lymph nodes

Take the baby to a doctor or casualty ward

  • Enlargement of auxiliary lymph node 

Vaccination should be postponed in case of

  • Acute illness
  • High fever
  • Serious skin disease

Treatment

  • Do not open vesicle or ulcer.
  • Do not apply any ointment directly onto injection site.
  • It is advisable to watch for any side effects.
  • Remain at clinic for at least 20 minutes after injection.

If in doubt, contact your clinic/clinic sister immediately.

 

Pentaxim injection, also called the 5-in-one injection, protects against the following: Diphtheria, Tetanus, Pertussis, Poliomylitis, Haemophilus influenzae type B

  • Injection in right upper thigh, 0, 5 ml intramuscularly
  • After 1 year, in the right upper arm

Side effects

  • Redness at the injection site
  • Fever
  • Diarrhoea/vomiting
  • Feeding/sleeping disturbances
  • Irritability

When to be worried

  • Redness and swelling > 5 cm at injection site
  • Fever > than 39º C
  • Drowsiness
  • Inconsolable crying

Take baby to doctor or casualty ward

  • Fever > 40º C
  • Convulsions, with or without fever, within 3 days of vaccination
  • Hypotonic reactions (collapse or shock-like state)
  • Rash
  • Persistent ,inconsolable crying lasting > 3 hours and occurring within 48 hours of vaccination

Vaccination should be postponed in case of

  • Fever > 39º C
  • Acute illness
  • Hypersensitivity to any components of the vaccine
  • Severe reaction to previous injections

Treatment

  • Only administer Panado syrup if temperature is higher than 38º C
  • 6 and 8 week old babies: Panado Infant drops, 0,6 ml, 4-6 hourly x 2 for fever
  • 10 and14 week old babies: Panado syrup, 2.5 ml, 4-6 hourly x 2 for fever
  • Older babies: Panado syrup 5 ml, 4-6 hourly x 2 for fever
  • Nurofen can also be used as indicated on the instruction pamphlet.
  • Apply hot face cloth (tested on mother’s forearm for correct temperature before applying to baby) on the injection spot every time you change the nappy, for 2 days.
  • Do not apply any ointment directly on injection site.
  • It is advisable to observe for any side effects.
  • Remain at clinic for at least 20 minutes after injection.
  • If in doubt, contact your clinic/clinic sister immediately for advice.

 

Prevenar injection is a Pneumococcal infection vaccine that protects against the following: Pneumonia and Otitis media, caused by Streptococcus pneumoniae, Meningitis, Bacteremia

  • Injection in right upper thigh, 0, 5 ml intramuscularly
  • After 1 year in the right upper arm

Side effects

  • Swelling, pain and tenderness
  • Fever
  • Diarrhoea/Vomiting
  • Decreased appetite
  • Drowsiness/restless sleep
  • Irritability
  • Crying

When to be worried

  • Redness and swelling > 2,4 cm at injection site, interfering with movement
  • Fever > than 39º C
  • Seizures, hypotonic-hypo responsive episode
  • Rash
  • Lymphadenopathy, localized to the region of injection site

Take baby to doctor or casualty ward

  • Fever > 40º C
  • Convulsions with or without fever within 3 days of vaccination
  • Hypotonic reactions (collapse or shock-like state)
  • Hypersensitivity reaction, including face oedema dyspnoea, bronchospasm (struggling to breathe)
  • Injection site pruritis (swelling, red and very sore)
  • Lymphadeopathy, localized to the region of injection site
  • Wheezing

Vaccination should be postponed in case of

  • Fever > 39º C
  • Acute illness
  • Hypersensitivity to the vaccine including Diphtheria toxoid
  • Not be given to infants with thrombocytopenia or any coagulation disorders
  • Sickle cell disease

Treatment

  • Only give Panado syrup if temperature is higher than 38º C
  • 6 and 8 week old babies: Panado Infant drops, 0,6 ml, 4-6 hourly x 2 for fever
  • 10 and 14 week old babies: Panado syrup, 2.5 ml 4-6 hourly x 2 for fever
  • Older babies: Panado syrup, 5 ml 4-6 hourly x 2 for fever
  • Nurofen can also be used as indicated on the instruction pamphlet.
  • Apply hot face cloth (tested on mother’s forearm for correct temperature before applying to baby) on the injection spot, every time you change the nappy, for 2 days.
  • Do not apply ointment directly on injection site.
  • It is advisable to observe for any side effects.
  • Stay at clinic for at least 20 min after injection.
  • If in doubt, contact your clinic/clinic sister immediately for advice.

 

Herberbiovac HB is a Hepatitis B vaccine: Hepatitis B virus

  • Injection in right upper thigh, 0, 5 ml intramuscularly

Side effects

  • Redness at the injection site
  • Fever
  • Diarrhoea/Vomiting
  • Feeding/Sleeping disturbances
  • Irritability

When to be worried

  • Redness and swelling > 5 cm at injection site
  • Fever > than 39º C
  • Drowsiness
  • Inconsolable crying

Take baby to doctor or casualty ward

  • Fever > 40º C
  • Convulsions with or without fever within 3 days of vaccination
  • Hypotonic reactions (collapse or shock-like state)
  • Rash
  • Persistent inconsolable crying lasting > 3 hours, occurring within 48 hours of vaccination 

Vaccination should be postponed in case of

  • Fever > 39º C
  • Acute illness
  • Hypersensitivity to any components of the vaccine
  • Severe reaction to previous injections

Treatment

  • Only give Panado syrup if temperature is higher than 38º C
  • 6 and 8 week old babies: Panado Infant drops, 0,6 ml 4-6 hourly x 2 for fever
  • 10 and14 week old babies: Panado syrup, 2.5 ml 4-6 hourly x 2 for fever
  • Nurofen can also be used as indicated on the instruction pamphlet
  • Apply hot face cloth (tested on mother’s forearm for correct temperature before applying to baby) on the injection spot every time you change the nappy, for 2 days.
  • Do not apply any ointment directly on injection site.
  • It is advisable to observe for any side effects.
  • Remain at clinic for at least 20 minutes after injection.
  • If in doubt, contact your clinic/clinic sister immediately for advice.  

                         

Rotarix is a Rotavirus gastro vaccine and protects against the following: Gastroenteritis caused by rotavirus

  • The vaccination course consists of 2 doses.
  • First doses should be given between 6 and 14 weeks.
  • Second doses between 14 and 24 weeks
  • Interval between doses: 4 weeks
  • Method of administration: oral only
  • Repeat if infant vomits, spits it out or regurgitates.
  • Not to be given after 24 weeks

Side effects

  • Irritability
  • Loss of appetite
  • Diarrhoea
  • Vomiting
  • Flatulence
  • Abdominal pain
  • Fever
  • Fatigue

When to be worried

  • Fever > than 39º C
  • Drowsiness
  • Inconsolable crying

Take baby to doctor or casualty ward

  • Fever > 40 º C
  • Convulsions with or without fever within 3 days of vaccination
  • Hypotonic reactions (collapse or shock-like state)
  • Persistent, inconsolable crying lasting > 3 hours, occurring within 48 hours of vaccination

Vaccination should be postponed in case of

  • History of chronic gastrointestinal disease
  • Uncorrected congenital malformation of the gastrointestinal tract
  • Diarrhoea or vomiting

Treatment

  • People in contact with recently immunised babies should be advised of the need for strict personal hygiene, particularly hand-washing after nappy changes for 3-4 days after the event.
  • Put soiled nappies in plastic bag before discarding for 3-4 days after immunisation.
  • It is advisable to observe for any side effects.
  • Stay at clinic for at least 20 minutes after injection.
  • If in doubt, contact your clinic /clinic sister immediately for advice.

 

Rouvax protects against the following: Measles

  • Injection in right upper thigh 0, 5 ml intramuscularly
  • After 1 year in the right upper arm

Side effects

  • Malaise (general feeling of unwellness)
  • Fever
  • Cough
  • Coryza (inflammation of the mucous membrane of the nose)
  • Rash
  • Pharyngitis
  • Headache

When to be worried

  • Fever > than 39º C
  • Drowsiness
  • Inconsolable crying

Take baby to doctor or casualty ward

  • Fever > 40º C
  • Convulsions with or without fever within 3 days of vaccination
  • Hypotonic reactions (collapse or shock-like state)
  • Persistent, inconsolable crying lasting > 3 hours, occurring within 48 hours of vaccination

Vaccination should be postponed in case of

  • Acute respiratory infection
  • Immuno-compromised patients
  • Immune deficiency syndrome
  • Human gabba globulin: for 3 months afterward
  • Egg protein and neomycin allergy

Treatment

  • Only give Panado syrup if temperature is higher than 38º C
  • Panado syrup: 5 ml, 4-6 hourly x 2 for fever
  • Nurofen can also be used as indicated on the instruction pamphlet.
  • Apply hot face cloth (tested on mother’s forearm for correct temperature before applying to baby) on the injection spot, every time you change the nappy, for 2 days afterwards.
  • Do not apply any ointment directly onto injection site.
  • After 5 to 10 days it might look as if your baby has measles, a runny nose, a cough, red and watery eyes, mild fever and a rash on the face and upper neck. These are not infections and only last for 2-3 days.
  • Put Calamine lotion on rash.
  • It is advisable to observe for any side effects.
  • Stay at clinic for at least 20 minutes after injection.
  • If in doubt, contact your clinic/clinic sister immediately for advice. 

 

Diftavax injection is a Td (tetanus, diphtheria) vaccine and protects against the following: Diphtheria (reduced dosage) and Tetanus Toxiod vaccine adsorbed on aluminum hydroxine

  • Injection in right upper arm, 0, 5 ml intramuscularly

Side effects

  • Redness at the injection site
  • Fever

When to be worried

  • Redness and swelling > 5 cm at injection site
  • Fever > than 39º C
  • Drowsiness
  • Inconsolable crying

Take child to doctor or casualty ward

  • Fever > 40º C
  • Convulsions with or without fever within 3 days of vaccination
  • Hypotonic reactions (collapse or shock-like state)
  • Rash
  • Persistent, inconsolable crying lasting > 3 hours, occurring within 48 hours of vaccination

Vaccination should be postponed in case of

  • Fever > 39º C
  • Acute illness
  • Hypersensitivity to any components of the vaccine
  • Severe reaction to previous injections

Treatment

  • Only give Panado syrup if temperature is higher than 38º C
  • Panado syrup: 10 ml, twice 6 hourly
  • Nurofen can also be used as indicated on the instruction pamphlet
  • Apply hot face cloth (tested on mother’s forearm for correct temperature before applying to the injection site) 4 times a day.
  • Do not apply ointment directly onto injection site.

Other vaccines not provided by the state

 

Infanrix Hexa
(Also called the 6-in-one injection)

Given at: 8, 12 and 16 weeks,18 months

Diphtheria

Tetanus

A cellular Pertussis

Haemophilis influenza type B

Hepatitis B

Polio (Inactivated Polio Vaccine)

Varilrix Given from: 9 months Chickenpox

Havrix Junior or Avaxim

     

Given at: 12 and 18 months

Hepatitis A

Havarix

     

Given at: over 16 years

Hepatitis A

Engerix B

Given at: 6,10 and 14 weeks and to children up to, and including,15 years

Hepatitis B

Twinrix

Given at: 1-15 years

Hepatitis A & B

Priorix or Trimovax
(Also called MMR)

Given at: 15 months and 4-6 years

Measles, Mumps, Rubella

Infanrix

Given at: 4-6 years

Diphtheria

Adacel Quadra

Given at: 6 and 11-18 years
Given to: adults

Tetanus
Pertussis

Cervarix Mencevax

Given to: females 10 years and older

Cervical cancer protection
Meningitis

Typherix

Given to: children age 2 years and older and adults Typhoid
Find out from your medical aid if they will pay for any of these vaccines.    

 

Reviewed October 2010 by Lizelle Prinsloo, registered nurse (M. Cur Verpleegkunde), part-time lecturer at the University of Pretoria and health advisor at a private baby clinic in Pretoria.

 
advertisement

Get a quote

advertisement

Read Health24’s Comments Policy

Comment on this story
3 comments
Add your comment
Comment 0 characters remaining

Live healthier

Allergy alert »

Allergy myths Cold or allergy? Children and allergies

Allergy facts vs. fiction

Some of the greatest allergy myths and misconceptions can actually be damaging to your health.

Vitamin wise »

Vitamins for HIV What to eat for vitamin B? Cut down on vitamins

All you need to know about vitamins

Find out which vitamin to use for which condition. Ask our Vitamin expert.