Childhood immunisation – the South African schedule explained
South Africa's routine childhood vaccines are free at public clinics. What the visits are for, why the timing matters, and what to do if you have fallen behind.
What the programme covers
South Africa's Expanded Programme on Immunisation provides routine childhood vaccines free of charge at public clinics, whether or not you have a medical aid and regardless of documentation status.
Between them, the routine vaccines protect against tuberculosis in its most severe childhood forms, polio, diphtheria, tetanus, whooping cough, hepatitis B, Haemophilus influenzae type b, pneumococcal disease, rotavirus and measles. Girls are additionally offered HPV vaccination through a school programme in Grade 5.
Where the schedule actually lives
Your child's Road to Health booklet is the authoritative record and schedule, and it is the one that gets updated when national policy changes. Take it to every visit, and keep it — it is also what a school or a new clinic will ask for.
The shape of the schedule is a birth visit, then visits at six, ten and fourteen weeks, then vaccines in the second half of the first year, around eighteen months, and boosters at school-going age. The exact vaccines given at each visit are printed in the booklet and are what your clinic will follow.
Why the timing matters
The intervals are not arbitrary. Early doses are timed for when a baby's own immunity starts replacing the protection passed on by the mother, and the repeat doses exist because one dose does not produce lasting protection for most of these diseases.
Being a little late is common and not a disaster. Being very late, or stopping after the first dose or two, leaves a child with partial protection that can look like full protection on paper.
If you have fallen behind
- Take the child and the Road to Health booklet to any clinic. You do not need an appointment.
- Say clearly which doses you think were missed, and let them read the booklet.
- You almost never have to start again from the beginning — catch-up schedules exist for exactly this.
- If the booklet is lost, go anyway. The clinic will work from what is known and restart records.
Side effects, and what is not one
A mild fever, irritability and a sore, red spot at the injection site for a day or two are expected and are signs the immune system is responding. The BCG given at birth typically leaves a small sore that heals over weeks into a scar.
Vaccines do not cause autism. That claim originated in a study that was retracted for fraud and has been contradicted by very large studies since.
Common questions
- Do vaccinations cost anything at a clinic?
- Routine childhood vaccines in the national programme are provided free at public clinics. You do not need a medical aid.
- My child is sick. Should we skip the appointment?
- A mild cold with no fever is usually not a reason to postpone. A significant fever or acute illness may be. Go to the clinic and let them decide rather than deciding at home — postponing repeatedly is how children fall behind.
- Can a child be vaccinated if they are HIV positive?
- Yes, and it matters more rather than less, because these infections are more dangerous in a child with HIV. A few live vaccines need clinical judgement depending on immune status, which is exactly what the clinic is there to assess.
Sources
- Expanded Programme on Immunisation (EPI-SA) and the Road to Health bookletNational Department of Health, South Africa
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
Last reviewed 4 August 2026.