what should you do if your child has missed a vaccination on the south african schedule: teddy bear getting vaccinated

Children should get all their vaccinations on time and according to the recommended schedule. However, there may be instances when a child does not get a specific vaccine or does not complete the required doses to offer protection.

During the COVID19 pandemic many children have fallen behind with their vaccines. Not because parents don’t want to vaccinate their children, but rather because they have been fearful of exposing their children to COVID19 if they take them out of the home to be vaccinated.

South Africa’s immunisation rates before lockdown were already suboptimal and now they are worse. As a result, researchers and healthcare providers fear that in the future there could be an outbreak in one of the preventable diseases such as measles or rotavirus.

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What should you do if your child has missed a vaccination, or if they’re behind on the South African vaccination schedule? If you have missed a vaccine(s) it is important to catch this up to offer complete protection to your child.

Can my child catch up if they are behind on their vaccinations?

Catch up schedules can be challenging for healthcare providers since each case needs to be evaluated on an individual basis. But it is never necessary to restart a schedule or repeat doses – rather, it is the interval between doses that is more important.

What’s the difference between the public and private vaccination schedule in South Africa?

Many private facilities offer a number of additional vaccines or combinations, however until 6 months of age the schedules are the same. It is possible for parents to change from one schedule to the next. What is important is that the one schedule is not better than the other. Some vaccines are simply not included in the National EPI because:

  • The pathogen does not cause severe disease in children (e.g. Varicella vaccine)
  • There is a low prevalence of the disease in the country
  • There is no scientific basis, nor any benefit provided by vaccinating the child
  • COST! Some formulations are more expensive than others. For the DoH to sponsor a vaccine, scientists need to provide strong evidence that the disease causes significant mortality and morbidity before they will consider including it in the EPI.

what should you do if your child has missed a vaccination on the south african schedule: child getting vaccinated

If my child has missed a vaccine will they need extra doses? 

Additional doses of a vaccine are usually given to make sure that everyone seroconverts. This basically means that there are detectable antibodies in the blood. Most vaccines require a series of three doses in childhood and may need some boosters in adulthood just to maintain immunity. Therefore the older a child gets, the fewer doses may be needed.

If a dose is missed or the interval between doses is extended, it is not necessary to restart the schedule, the missed doses should be given following the correct intervals going forward. The vaccines effectiveness will not be reduced, but it will take longer to achieve optimal immunity.

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Does my child need all the vaccines on the schedule?

Some vaccines are no longer necessary in older children. For example the Pneumococcal and Haemophilus Influenza type B vaccines. The infections these germs cause mostly occur before the age of five years and therefore these vaccines are not necessary in healthy children over the age of five.

My child has behind on his vaccination schedule. Is it still safe for him to be vaccinated if he is older?

Some vaccines can cause complications in older children. The Rotavirus vaccine for example, should only be given up until 32 weeks. If given after this age it can cause a complication in the infant known as intussusception, which is a medical emergency.

What can I do if I don’t want to take my child to the clinic for his vaccinations?

With winter approaching it’s even more important that your children’s vaccines are caught up. Make an appointment to see your healthcare provider and discuss your options. If you still do not want to risk taking your child out of the home to be vaccinated there are some providers – like LILAQ Health – who offer home consultations in select areas.

Dr Carmen - MomDoc BabyYumYum Expert
GENERAL PRACTITIONER AND #MOMDOC Dr Carmen is a medical practitioner, having spent most of her career in the emergency and trauma room. She loves the adrenalin rush of it all, plus the copious amounts of caffeine helped make the long shifts more bearable. Seeing patients in an emergency setting after an accident or with chronic end-stage disease, however, made her realise that her real passion lies in disease prevention, health education and promotion. As they say, prevention is better than cure, and she wanted to try to help people before they ended up in the ER. This led her to complete her Masters in Public Health, focusing on child health and starting her business, OneAid. She loves to use social media as a tool to share information about various public health issues in an effort to spark up conversations to drive behaviour change and education.