Health on Expanded Programme on Immunisation

Clarification on the Expanded Programme on Immunisation-SA
(EPI-SA) schedule by the Department of Health

8 March 2007

It has come to the attention of the national Department of Health that some
representatives of certain vaccine producing companies are informing health
professionals and the public that Hepatitis B vaccine should be given at birth.
This is certainly not part of the EPI schedule that the Department of Health
follows.

According to the EPI-SA schedule there is no Hepatitis B vaccine dose at
birth. Hep B vaccine is given at the same time with DPT-Hib (haemophilus
influenzae type b vaccine) at: 6, 10 and 14 weeks. This schedule is the most
suitable for South Africa and has taken into consideration the prevalence of
Hepatitis B infection in the country. The schedule was developed in
consultation with the United Nations International Children's Emergency Fund
(UNICEF) and the World Health Organisation (WHO) and is currently followed by
all provincial Departments of Health in the country and by a large number of
other countries with socio-economic and disease patterns similar to South
Africa.

The current EPI schedule is as follows:
Schedule for Childhood Immunisation EPI-SA
Age: Vaccine
Birth: TOPV (0)
BCG

6 weeks: TOPV (1)
DTP- Hib (1)
Hep B (1)

10 weeks: TOPV (2)
DTP-Hib (2)
Hep B (2)

14 weeks:TOPV (3)
DTP - Hib (3)
Hep B (3)

9 months: MEASLES (1)
18 months: TOPV (4)
DTP
MEASLES (2)

5 to 7 years (school entry): TOPV (5), Td
12-15 years (school leaving): Td

Kindly note: the current schedule goes up to five years, with a DT dose at
five years. A Td at five years to replace DT and an additional dose of Td at 12
years is soon to be introduced.

TOPV: Trivalent Oral Polio Vaccine
DTP: Diphtheria, Tetanus and Pertussis Vaccine
DT: Diphtheria and Tetanus Vaccine
Hep B Hepatitis B Vaccine
BCG: Bacillus Calmette Guerin (Anti-tuberculosis Vaccine)
Hib: Haemophilus influenzae type b vaccine

The national Department of Health is however aware that a certain vaccine
product, Infanrix Hexa which is a combination of: diphtheria, tetanus,
acellular pertussis, inactivated polio, Hepatitis B and Haemophilus influenza
can only be used at 6, 10 and 14 weeks if a Hepatitis B dose was given at
birth. This is the requirement of this product and has no relevance to the
EPI-SA schedule, as this product is not part of the EPI schedule and is only
available to a minority of the population that makes use of the private
providers who may prefer to use this product. There is neither scientific basis
nor any benefit provided by subjecting newborns to an injection of a Hepatitis
B dose.

The Department of Health and the Expanded Programme on Immunisation (EPI-SA)
is deeply concerned by the confusion on the Immunisation schedule caused by the
marketing of this product. Health Professionals are alerted to the fact that
there is no need to give Hepatitis B vaccine at birth if they are following the
EPI schedule, using the vaccine products that are part of the EPI-SA
schedule.

Queries:
Dr Ntombenhle J Ngcobo:
Expanded Programme on Immunisation:
Tel: (012) 312 0099

Enquiries:
Fidel Hadebe
Tel: (012) 312 0663
Cell: 079 517 3333
Bhungani Mzolo
Tel: (012) 312 3331
Cell: 083 589 4999

Issued by: Department of Health
8 March 2007

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