Should you, shouldn’t you – there’s so much con­flict­ing ad­vice out there, what’s a new mom sup­posed to do? With the lat­est in­for­ma­tion on vac­cines and herd im­mu­nity you can make an in­formed de­ci­sion

Your Baby & Toddler - - THE DOSSIER - BY ANNA SUT­TON

It’s been over 200 years since the first vac­ci­na­tion was given. Since then mil­lions of lives have been saved, thanks to a host of vac­cines be­ing made freely avail­able across the planet. Yet, in some first­world coun­tries par­ents are choos­ing to opt out of state vac­cine pro­grammes. The ef­fects are start­ing to be seen with break­outs of dis­eases that have been prac­ti­cally non-ex­is­tent for decades. Measles, for ex­am­ple, was de­clared elim­i­nated in the US 15 years ago. But in 2014 an un­vac­ci­nated trav­eller vis­ited Dis­ney­land, was ex­posed to a per­son suf­fer­ing from measles, and went on to in­fect more than 100 peo­ple. Sim­i­lar out­breaks have been seen in Aus­tralia, Canada and Europe.

South Africa also ex­pe­ri­enced a measles out­break be­tween 2009 and 2011 with 18 000 cases, ac­cord­ing to the Na­tional In­sti­tute for Com­mu­ni­ca­ble Dis­eases (NICD). There were a sig­nif­i­cant num­ber of deaths and long-last­ing dam­age to chil­dren from this out­break. Ad­di­tion­ally, South Africa ex­pe­ri­enced a to­tal of 15 cases of diph­the­ria – and four deaths from this bac­te­rial in­fec­tion – be­tween April and July 2015.

The measles virus, which, ac­cord­ing to the World Health Or­gan­i­sa­tion (WHO), is one of the lead­ing causes of death among young chil­dren, is so con­ta­gious that 90 per­cent of the peo­ple close to a per­son who is not im­mune to it will also be­come in­fected. This is why main­tain­ing what doc­tors term “herd im­mu­nity” for this virus, among oth­ers, is crit­i­cal.


Vac­cines work in two ways, ex­plains Dr Melinda Suchard of the Cen­tre for Vac­cines and Im­munol­ogy at the NICD. “The first way is the ob­vi­ous way, in that it will pro­tect your child from ac­quir­ing that dis­ease. The sec­ond way it works is pre­vent­ing your child from spread­ing the dis­ease. So hav­ing your child vac­ci­nated will in fact pre­vent your child be­ing a link in the trans­mis­sion into some­body else,” she says.

This is very im­por­tant be­cause there are some peo­ple who just can­not be vac­ci­nated. Chil­dren who are too young (be­low the age at which you can give a vac­cine; for measles, for ex­am­ple, younger than six months); or chil­dren with spe­cific med­i­cal con­di­tions and com­pro­mised im­mune sys­tems, such as leukaemia, are un­able to be vac­ci­nated. Dr Suchard also ex­plains that vac­cines are not ef­fec­tive for every­one, so there will be about five per­cent of the com­mu­nity who are sus­cep­ti­ble to in­fec­tions even though they have been vac­ci­nated. “Vac­ci­nat­ing your child helps pro­tect the whole com­mu­nity. It’s also crit­i­cal to have high vac­ci­na­tion lev­els as part of a co­or­di­nated global ef­fort to try to in­ter­rupt trans­mis­sion of dan­ger­ous cir­cu­lat­ing viruses and bac­te­ria and to en­sure cov­er­age if there is an in­fected trav­eller who comes into the coun­try, or any im­por­ta­tion of a virus,” she says. A suc­cess story of global vac­ci­na­tion pro­grammes is the erad­i­ca­tion of small­pox in the 1970s, which means no one needs to be vac­ci­nated against it any­more.


Small­pox may be one less vac­cine your baby re­quires, but over the course of the next 12 years she will get close to 20 shots. Get­ting your head around the fact that she needs to be in­jected with a dis­ease to ul­ti­mately pro­tect her can be dif­fi­cult, but un­der­stand­ing how vac­cines work should al­lay your fears.

Whether you de­cide to vac­ci­nate your child by fol­low­ing the gov­ern­ment Road To Health card, or go to a pri­vate clinic, re­ally comes down to ques­tions of cost and con­ve­nience and what your time or bud­get al­lows. At a state clinic all the vac­cines on the Depart­ment of Health’s Ex­tended Pro­gramme on Im­mu­ni­sa­tion (EPI SA) are of­fered for free. The dis­ad­van­tage is that you can’t book an ap­point­ment so you may ex­pe­ri­ence long waits at the baby clinic. You also won’t get the “per­sonal touch” and fol­low-up con­tact you get from a pri­vate nurs­ing sis­ter. How­ever, you could al­ways con­tact the vac­cine helpline Amayeza on 0860 160 160 for ad­vice and in­for­ma­tion.

The ma­jor ben­e­fit of the EPI SA is that all the vac­cines are of­fered for free, whereas if you go to a pri­vate clinic you will have to pay for each vac­cine as well as an ad­di­tional con­sul­ta­tion fee, which can range from R100 to R300.

“In the past, at some of the pri­vate clin­ics you could also get some of the vac­cines from the state so you wouldn’t have to pay for them, but this was stopped at the end of last year,” says Sis­ter In­grid Groe­newald, a reg­is­tered nurse and pri­vate mid­wife. It can be­come very ex­pen­sive if you don’t have med­i­cal aid to cover it. “The vac­cines your baby needs at six and 14 weeks can add up to al­most R2 000 for each visit and if you are al­ready earn­ing less be­cause you are on ma­ter­nity leave or haven’t been paid out your ben­e­fits yet, this can cause fi­nan­cial pres­sure,” says Sr In­grid. She rec­om­mends you start putting aside some money for the vac­cines while you are still preg­nant, or ask­ing friends or fam­ily to gift the money for vac­cines in­stead of giv­ing your baby toys or clothes at birth.

The qual­ity of state and pri­vate sup­plied vac­cines don’t dif­fer. “Both sched­ules are ex­cel­lent,” con­firms Dr Suchard. “The state sched­ule is based on what is go­ing to pro­tect South Africans from a herd im­mu­nity per­spec­tive,

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