Other Vaccines

TT (Tetanus Toxoid)

Human Papillomavirus (HPV) Vaccine

Hepatitis B

Influenza Vaccine

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TT (Tetanus Toxoid)

Z23.5

Protects against tetanus (post trauma)

• TT, IM, 0.5 mL into arm
  •  
  • Storage:
    • Fridge: middle shelf at 2–8°C.
    • Easily damaged by freezing.
    • Keep opened vials for next session if kept at correct temperature and not contaminated.
    •  Discard after 30 days.
    • Record date of reconstitution.
  • Contraindications:
    • Previous anaphylaxis.

Trauma

• Give booster dose of TT/Tdap after every traumatic injury (unless administered in previous 5 years).

Human Papillomavirus (HPV) Vaccine

Z25.8

Protects against infection with HPV serotypes 16 and 18.
Persistent HPV infection is associated with the development of several reproductive tract cancers, especially cancer of the cervix.
A single dose is offered as part of the Integrated School Health programme to Grade 5 girls (≥ 9 years of age) in public schools.

• HPV, IM, 0.5 mL
  • Administered into the deltoid of the non-dominant arm.
  • Storage:
    • Fridge: middle shelf at 2–8°C.
    • Easily damaged by freezing – do not freeze and discard any vaccine which has been frozen.
    • Store in original package and protect from light.
    • Use immediately once withdrawn into a syringe.
  • Contraindications:
    • Previous anaphylaxis to the vaccine.
    • Febrile illness (≥ 38.5°C).
    • Should not be administered to girls/women who are known to be pregnant.
  • Adverse events:
    • Injection site pain and swelling in the arm are common.
    • Itching, rash, redness and urticaria may also occur.
    • Nausea, diarrhoea, abdominal pain, headache, myalgia, fever (38°C) are not uncommon.
    • Syncope, dizziness, lymphadenopathy, and anaphylaxis have been reported.

Hepatitis B

Z24.6

All personnel working in a health care facility (including support staff) and student 
health care workers.

• Hepatitis B vaccine, IM, 3 adult doses of 1 mL.
  • first dose administered immediately;
  • second dose 1 month after the first dose;
  • third dose 6 months after the first dose.

 

Perinatal transmission

Babies born to mothers with acute hepatitis B infection at the time of delivery or to mothers who are HBsAg-positive or HBeAg-positive, See: Perinatal transmission of hepatitis B.

Influenza Vaccine

Z25.1

• Influenza vaccine, IM, 0.5 mL
  • Trivalent influenza vaccine or quadrivalent influenza vaccines may be used, depending on cost and availability considerations.
  • Contraindication: < 6 months of age.
  • Severe egg allergy is not a contraindication to the inactivated influenza vaccine. However, it is recommended that individuals reporting a history of severe egg allergy are vaccinated in a setting equipped to manage allergic reactions.
    LoE:IVb¹
  • Based on available data and resources, the following groups are prioritised for influenza vaccination in the annual influenza campaign and during influenza or COVID-19 pandemic:
    LoE:IVb²
    • Healthcare workers
    • Age > 65 years
    • People with the following risk factors for severe influenza:
      - Chronic cardiac or pulmonary conditions (including chronic heart disease, hypertension, stroke, and diabetes), chronic lung disease (including asthma and chronic obstructive pulmonary disease) and malignancy
      - HIV infection
      LoE:IVb³
    • Pregnant women at all stages of pregnancy, including women up to 6 weeks postpartum
  • Commercially available products may differ in terms of the age-groups in which they can be used – check the specific package insert.
  • General recommended dosage of influenza vaccine for patients of different age groups:

Age group	Dose	Number of doses
-Trivalent influenza vaccine:
Adults and children ≥ 9 years	0.5 mL, IM	Single dose.
Children: > 3 to < 9 years	0.5 mL, IM	2 doses ≥ 4 weeks apart during first year of immunisation, thereafter one dose per annum.
Children: > 6 months to < 3 years	0.25 mL, IM	2 doses ≥ 4 weeks apart during first year of immunisation, thereafter one dose per annum. LoE:IIIb4
- Quadrivalent influenza vaccine:
Adults and children ≥ 9 years	0.5 mL, IM	Single dose
6 months to < 9 years	0.5 mL, IM	2 doses ≥ 4 weeks apart during first year of immunisation, thereafter one dose per annum. LoE:IIIb5

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Note:
- The influenza vaccine should not be given at the same time as the live measles/rubella vaccine at 6 months of age. 
- Influenza vaccines can be given concurrently with other injectable vaccines, but must be administered at different injection sites.

LoE:IVb⁶

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Click here to access the pdf.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.1_6 December 2024

Chapter 13: Immunisation_13.7 Other Vaccines