Every vaccine on the immunisation schedule South Africa uses in its public clinics is free, from the two shots given at birth to the booster at 12 years. No medical aid, no appointment and no fee. The schedule is set by the Expanded Programme on Immunisation, EPI-SA, and was last revised in 2024, when the measles vaccine at 6 and 12 months was replaced with a combined measles and rubella shot.
The reminder is timely. Gauteng’s health department said on 7 September 2026 that immunisation coverage in the first quarter of the 2026/27 financial year sat at 72% for children under one year, against a national target of 90%, and 70.7% for the second dose of the measles and rubella vaccine. Tshwane was the weakest district at 59.2%, followed by Sedibeng at 69.5%. West Rand was the strongest at 90.6%.
The routine schedule
| Age | Vaccines |
|---|---|
| Birth | BCG, oral polio (OPV-0) |
| 6 weeks | OPV-1, rotavirus 1, pneumococcal 1, hexavalent 1 |
| 10 weeks | Hexavalent 2 |
| 14 weeks | Rotavirus 2, pneumococcal 2, hexavalent 3 |
| 6 months | Measles and rubella 1 |
| 9 months | Pneumococcal 3 |
| 12 months | Measles and rubella 2 |
| 18 months | Hexavalent 4 |
| 6 years | Tdap 1 |
| 12 years | Tdap 2 |
The hexavalent shot covers six diseases in one injection: diphtheria, tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b. Tdap covers tetanus, diphtheria and pertussis.
Two campaign-based vaccinations sit outside the clinic visits. Tdap is given to Grade 5 learners, and the human papillomavirus vaccine is given in two doses to girls aged 9 and older, also in schools.
Three rules from the national schedule that parents ask about:
- The hepatitis B birth dose is given only to babies whose mothers tested positive for HBsAg during pregnancy.
- Rotavirus vaccine is not given after 24 weeks. If you miss that window, the dose is gone, but the rest of the schedule carries on normally.
- The measles and rubella dose given between 6 months and 9 months must not be given with any other vaccine on the same day. From 9 months it can be combined with others.
If your child has missed doses
A missed dose does not mean starting the series again. The clinic picks up from where the record stops, and previous doses stay valid no matter how long ago they were given. The national catch-up schedule sets upper age limits for each vaccine:
| Vaccine | Catch-up limit |
|---|---|
| BCG | 12 months |
| Oral polio birth dose | 6 months |
| Hexavalent | 59 months |
| Rotavirus | 24 weeks |
| Pneumococcal | 72 months |
| Tdap | 15 years |
| Measles and rubella | No upper age limit |
Take the Road to Health booklet with you. If it has been lost, go anyway. The national department’s guidance is that health workers must assist and give catch-up doses where needed rather than turn a child away. Clinics are also expected to check missed doses whenever a child up to 12 years old presents for any reason, including curative visits, hospital admissions and school health visits.
Most clinics vaccinate in the morning, so go early.
Why the numbers matter
The department counts a child who has not had the first hexavalent dose as a zero-dose child. In the 2023/24 financial year the districts with the highest proportions of zero-dose children were O.R. Tambo and Alfred Nzo in the Eastern Cape, at 41% and 40%, and Bojanala in North West and Harry Gwala in KwaZulu-Natal, both at 34%. By number, the biggest gaps were in Johannesburg, eThekwini and Ekurhuleni.
Measles spreads faster than almost any other infection, and the national target for measles coverage is 95%, higher than the 90% target for general under-one coverage, precisely because gaps in a community are enough to let an outbreak start.
Watch for these symptoms
Gauteng’s health department asked parents of unvaccinated or partly vaccinated children to watch for fever, rash, a persistent cough, muscle weakness, neck stiffness, jaundice, severe headache or seizures, and to take the child to a clinic rather than wait.
What it costs outside the state system
The same vaccines are available from private doctors and pharmacies, at a price. Private schedules also carry vaccines outside the state programme, including chickenpox, hepatitis A and the combined measles, mumps and rubella shot. Medical schemes usually pay childhood vaccinations from a preventive care benefit rather than from savings, but that varies by plan, and scheme contributions rise every year, as set out in the medical aid price increases.
Clinics ask for identity documents when they open a file for a child. If the birth has not been registered yet, see how to get an unabridged birth certificate. Families using clinic services for a young child may also qualify for the SASSA child support grant.
Where to check
The Expanded Programme on Immunisation schedule, the vaccinator’s manual and the catch-up tables are published by the National Department of Health on its knowledge hub at knowledgehub.health.gov.za. Your nearest clinic can confirm which doses are outstanding from the Road to Health booklet.
