Vaccinations in South Africa: Health Requirements for Expats

This guide explains everything you need to know about vaccinations in South Africa, including the following:

• The South African vaccination system

• Insurance for vaccinations in South Africa

• Childhood vaccinations in South AfricaMandatory and recommended vaccinationsOther optional vaccinations in South Africa

• Mandatory and recommended vaccinations

• Other optional vaccinations in South Africa

• Vaccination schedule in South Africa

• COVID-19 vaccinations in South Africa

• Vaccinations for pensioners in South Africa

• Vaccinations for special groups in South Africa

• Travel vaccinations in South Africa

• Useful resources

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The South African vaccination system

As with other countries, you should be aware of some diseases before you move to South Africa. Indeed, infectious diseases are generally a major concern throughout the continent, although these concerns are far less prevalent than elsewhere on the continent.

Vaccinations in South Africa are managed by the National Department of Health, with support from the National Advisory Group on Immunization (NAGI). Through the Expanded Programme on Immunization (EPI), the country offers free routine childhood vaccines, such as BCG, polio, and measles.

Vaccines aren’t mandatory, but they are widely available and generally well accepted, especially for children. In the last decade, however, vaccine hesitancy has been on the rise, particularly following the rollout of COVID-19 vaccines. The government responded with public education campaigns and a digital registration system, the Electronic Vaccination Data System (EVDS).

The healthcare system in South Africa

Insurance for vaccinations in South Africa

Through its public healthcare system, South Africa ensures that the majority of childhood vaccinations are free (or low-cost) and universally available to all residents. Vaccines that are not included may be covered by many insurance providers, including these global companies catering specifically to expats:

• Allianz Care

• Cigna Global

Getting medical aid or insurance in South Africa

Childhood vaccinations in South Africa

Children in South Africa receive free vaccinations at public clinics. Expat children also have the option to get vaccinated at a private clinic, which, of course, requires private insurance coverage.

If you just had a baby, your newborn(s) will get immunized at the hospital.

Mandatory and recommended vaccinations

South Africa doesn’t have mandatory vaccinations. However, the following are strongly recommended:

Vaccine

Diseases and infections it protects against

Number of doses

BCG vaccine

Tuberculosis

One

Hexavalent vaccine (DTaP-IPV-Hib-HBV)

Diphtheria, tetanus, whooping cough (pertussis), polio, Hib disease, and Hepatitis B

Four

HPV (Cervarix) vaccine

Human papillomavirus

One

MR vaccine

Measles/Rubella (MR)

Two

OPV vaccine

Polio

Two

PCV vaccine

Streptococcus pneumoniae bacteria (like pneumonia, meningitis, and blood poisoning)

Three

RV vaccine

Rotavirus

Two

Tdap vaccine

Tetanus, diphtheria, and whooping cough (pertussis)

Two

Other vaccines available within the public system (though not within the scope of the EPI):

• COVID-19

• Influenza

• Meningococcal Meningitis

• Yellow Fever

Other optional vaccinations in South Africa

South Africa’s private sector offers the following additional vaccines:

• MCV

• MMR

• MMRV

• Varicella

• Hepatitis A

• Tdap-IPV

• HPV (Gardasil)

Vaccination schedule in South Africa

The following is a recommended schedule for vaccinations in South Africa:

Age

Vaccine

Birth

First (only) dose of BCG vaccine

Less than 6 months

First and second dose of OPV vaccineFirst and second dose of PCV vaccine

9 months

Third dose of PCV vaccine

Less than 11 months

First dose of MR vaccine

12 months

Second dose of MR vaccine

Less than 20 months

First and second dose of RV vaccine

Less than 24 months

Second dose of RV vaccine

Less than 5 years

First dose of Hexavalent vaccine, second and third dose after four-week intervals, and fourth dose 12 months after the third one

Less than 6 years

First dose of Tdap vaccine

9 years and older

First (only) dose of HPV (Cervarix) vaccine

12 years

Second dose of Tdap vaccine

COVID-19 vaccinations in South Africa

Anyone over 12 can access COVID-19 vaccines throughout South Africa, free of charge. You can visit the website of the National Institute for Communicable Diseases for any recent COVID-19 updates and vaccine mandates.

Vaccinations for pensioners in South Africa

Adult vaccinations are not mandatory in South Africa. However, doctors encourage anyone over 60 to get vaccinated against:

• Common flu

• Herpes zoster (shingles)

• Pneumococcal diseases (PCV13 and/or PPSV23)

Medical workers at community health centers typically administer vaccines for seniors, but nursing staff at local hospitals or medical care facilities can do it as well. On very rare occasions, the pharmacy may also provide certain vaccinations.

Vaccinations for special groups in South Africa

Beyond routine schedules, certain groups in South Africa receive special vaccination recommendations. For example:

• Pregnant people, it’s recommended that you get vaccinated against influenza and Tdap during every pregnancy (typically between 26 and 34 weeks). Pregnant people are also advised to get the routine antenatal tetanus shots.

• Patients living with HIV, you’re encouraged to get the annual flu vaccine, regardless of your CD4 count. HIV patients are also recommended to get vaccinated against pneumococcal diseases. Additional vaccines such as Hepatitis A/B and HPV may be advisable based on your individual risk assessment.

• Healthcare workers, you’re strongly advised to get all three doses of the Hepatitis B vaccination, along with the standard adult vaccines like influenza and Tdap.

Travel vaccinations in South Africa

All travellers to South Africa must be up to date with routine vaccinations, such as MMR, Polio, and Tdap. Depending on your country of origin, you may need additional vaccines, for example:

• Cholera (only when travelling to regions experiencing active cholera outbreaks)

• Hepatitis A and B

• Typhoid

• Rabies

Be sure to check with your embassy or family doctor (GP) before your departure.

Useful resources

• National Department of Health, official government website for the federal ministry responsible for national healthcare in South Africa

• National Institute for Communicable Diseases, official government website for the agency in charge of disease control and outbreak response