Immunizations in Malawi
Schedule for immunization
| Time |
Vaccine |
| Birth |
BCG and OPV (polio 0) |
| 6 weeks |
OPV 1 and DPT-HepB-Hib1 and PCV 1 and Rotavirus vaccine 1 |
| 10 weeks |
OPV 2 and DPT-HepB-Hib2 and PCV 2 and Rotavirus vaccine 2 |
| 14 weeks |
OPV 3 and DPT-HepB-Hib3 and PCV 3 |
| 9 months |
Measles and Rubella 1 |
| 15 months |
Measles and Rubella 2 |
BCG: Bacille Calmette - Guerin vaccine
OPV: Oral polio vaccine
DPT-HepB-Hib: Diphtheria and Tetanus and Pertussis and Hepatitis B and H. influenzae type b
PCV: Pneumococcal conjugate vaccine
Tetanus Toxin
| Date |
vaccine |
| First contact (15-45 yrs and pregnant women) |
TT 1 |
| 4 weeks after TT 1 |
TT 2 |
| 6 months after TT 2 |
TT 3 |
| 1 year after TT 3 |
TT 4 |
| 1 year after TT 4 |
TT 5 |
TT: Tetanus toxoid
TTV In injuries
If the last dose of the primary series, or of subsequent booster injections was given less than 5 years ago for dirty wounds or less than 10 years ago for clean wounds no booster is needed. Otherwise vaccinate (WHO recommodation).
Vitamin A
| Time |
Supplement |
| At 6 months and after every 6 months up to 59 months |
Vitamin A (children) |
| Within 2 weeks of delivery |
Vitamin A (postnatal mothers) |
Further changes
- Introduction of Inactivated Polio Vaccine (IPV) in Malawi has been delayed to possibly Q4 of 2017
- Introduction of Human Papillomavirus vaccine (HPV) in Malawi will be in 2018
According to WHO guidelines, a child is considered fully immunized if he or she has received:
- a vaccination against tuberculosis (BCG)
- three doses of diphtheria, pertussis and tetanus (DPT) vaccine
- three doses of pneumococcal conjugate vaccine (PCV)
- at least three doses of polio vaccine
- one dose of measles vaccine.
General Points to Remember
- Always enquire about immunization in any child that comes to hospital
- Immunization should be given with informed parental/guardian consent
- There are very few contraindications to immunization, if in doubt, consult seniors
- Immunisations are given at all health centres and under 5’s clinics
Important points in history
- Fever
- Evidence of vaccinations (BCG scar on deltoid)
Contraindications to Immunisation
- Severe local or generalised reaction
- Acute febrile illness (delay immunisation), acute diarrhoea with OPV
- When in doubt consult the seniors
Immunisation in HIV
- BCG is contraindicated in symptomatic HIV infection (NOT neonatal BCG)
- Measles, polio, rotavirus, PCV, pentavalent vaccine are ALL INDICATED
Immunisation Reactions
- Mild reaction with symptoms of mild fever, local tenderness, irritability, malaise and crying are common
- These are not contraindications to further immunization.
- Severe reactions (anaphylaxis) are rare, but be prepared!
- All immunisation reactions must be reported