South Africa vaccination schedule: which vaccines your baby gets and when

The EPI-SA vaccination schedule

This is the revised routine schedule the National Department of Health introduced in 2024. Check it against the immunisation page of your child's Road to Health Book.

Age	Vaccines
Birth	BCG (tuberculosis); oral polio (OPV 0)
6 weeks	Oral polio (OPV 1); rotavirus (RV 1); pneumococcal (PCV 1); hexavalent 1
10 weeks	Hexavalent 2
14 weeks	Rotavirus (RV 2); PCV 2; hexavalent 3
6 months	Measles-rubella (MR 1) — given on its own, not with other vaccines
9 months	PCV 3
12 months	Measles-rubella (MR 2)
18 months	Hexavalent 4 (booster)
6 years	Tdap 1 (tetanus, diphtheria, whooping cough booster)
Grade 5 girls, 9 years and older	HPV (against cervical cancer), at school
12 years	Tdap 2

The hexavalent vaccine is the "6-in-1": it protects against diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B in one injection. In the book it may be written as DTaP-IPV-Hib-HBV.

What changed recently

• Measles became measles-rubella (MR) in 2024. The ages stayed the same — 6 and 12 months — but the vaccine now also protects against rubella, which can harm unborn babies.
• The school boosters became Tdap in 2024, adding whooping cough protection.
• HPV is given to Grade 5 girls aged 9 and older through the school health programme. Gauteng's 2026 campaign uses a single dose. Schools ask for a signed consent form, so look out for it and send it back.

Some babies also get a hepatitis B dose at birth. This is only for babies whose mothers tested positive for hepatitis B in pregnancy — your clinic will tell you if this applies.

My child missed a vaccine — do we start again?

No. The World Health Organization's rule is that an interrupted series is continued, not restarted, and doses already given are not repeated — however long the gap.

• Go to the clinic as soon as you can with the Road to Health Book. You don't need to wait for a special day.
• Clinic staff are asked to check the book every time a child under 12 comes in, even for something else. Use that.
• Late is better than never. But some vaccines have age limits in the national catch-up schedule:

Vaccine	Catch-up limit (national schedule)
Rotavirus	Not given after 24 weeks
Oral polio	Not given from 6 months
BCG	Under 1 year
Hexavalent	Up to 5 years
PCV	Up to 6 years
Measles-rubella	No upper age limit
Tdap	Up to 15 years

The rotavirus limit is the one parents most often miss. If your baby is close to 14 weeks and hasn't had their 6-week vaccines, go this week.

Lost the book? Go anyway. The clinic will still help, and staff decide what your child needs.

Normal side effects after vaccines

Most reactions are mild and settle within a day or two:

• Pain, redness or swelling where the injection went in.
• A mild fever.
• Being grumpy, sleepy or feeding a little less.
• Sometimes vomiting or loose stools.

BCG is different. About 2 weeks later a small blister or sore can appear on the arm. It scabs over, can take weeks or months to heal, and leaves a small flat scar. That is expected. Leave it uncovered, don't put a plaster on it, don't squeeze it and don't put creams or home remedies on it. Show it to the clinic if it gets very red, swollen or full of pus.

What you can do at home:

• Keep breastfeeding — more often if your baby wants.
• Light clothing if your baby is hot.
• If your baby is very uncomfortable with fever or pain, you can give paracetamol at the dose on the package or as the nurse or pharmacist advises. Never give aspirin to children.

When a reaction is worrying

Serious reactions are very rare. A severe allergic reaction usually starts within minutes, and clinic staff are trained to treat it — that's why it's worth waiting a few minutes before you leave.

Once you're home, go back to the clinic or casualty if you see any of the danger signs in the red box at the top. A fever that starts days later, or doesn't go away, may not be the vaccine at all — get it checked. Read more in fever in babies and children.

Keep the Road to Health Book safe

The Road to Health Book is your child's main health record until school age. It holds:

• Every vaccine and the date it was given.
• Vitamin A and deworming doses.
• The growth chart, which shows whether your child is growing well (see baby weight and height by age).

A few tips:

• Keep it in a plastic sleeve, away from water.
• Take it to every clinic, doctor or hospital visit — public or private.
• Photograph the vaccine pages on your phone, in case the book gets lost or damaged.
• Check that the next appointment date is written in before you leave.

An app like Iasora can remind you when the next vaccine is due, but the book is still the official record clinics and schools ask for.

Common questions

Do I have to pay for vaccines?

No. All vaccines on the national schedule are free at public clinics. Private doctors and pharmacies also vaccinate, but charge for it, and some offer extra vaccines that are not on the government schedule.

Can my baby be vaccinated with a cold?

A mild cold usually isn't a reason to delay. If your baby has a high fever or seems unwell, tell the nurse — they will decide whether to vaccinate on the day.

Aren't several injections on one day too much?

No. The schedule is designed to give several vaccines safely at one visit. Spacing them out only means more trips and leaves your baby unprotected for longer. The one exception is the 6-month measles-rubella dose, which is given on its own by design.