Immunizing your child is one of the most effective ways to protect him or her from disease and death. Malawian nurses have told me how wards were full of kids sick with meningitis, pneumonia, complications from measles, etc… before Malawi started widely immunizing. Tragically, it was common for children to die in the pediatric wards.
Now on the scheduled immunization clinic day, Malawian moms wake up early, clean and dress their babies, and walk as far as it takes to ensure their babies get immunized. Because of their commitment to immunizing their children, I don’t have to care for wards of sick and dying children. In fact, thanks to immunizations, I haven’t seen those scary illnesses that the Malawian nurses remember. I get to spend my clinic days caring for generally happy, healthy babies with minor viral illnesses and the occasional case of malaria.
Here is a comprehensive list of immunizations for global kids living in Malawi. This list can be used to ensure that your child is up to date on immunizations per the CDC guidelines. It was developed from the Malawian government’s expanded program, CDC’s routine immunizations, the CDC’s recommendations for traveler’s to Malawi, and input from others working with international patients.
Immunization List for Global Kids Living in Malawi-revised December 10, 2020
Ensure all Malawian government immunizations up to date :
(Below is the Malawian immunization schedule. Second and third doses given 4 weeks after previous dose. Note the timing is different than the American CDC guidelines. See Immunization Schedule Based on CDC guidelines using Malawian Vaccines for CDC-like schedule.)
BCG ___________ (Birth) (Recommended by Malawi, but not on CDC list. Over 3-6 months need negative TB skin test before giving.)
Hepatitis B #1__________(6 wk), #2 _____________, #3______________
DPT #1 __________(6 wk), #2 _________________, #3_______________
Hib #1 ___________(6 wk), #2 ________________, #3______________ (1 dose if unvaccinated at 15-59 mo.)
PCV13 #1 __________(6 wk), #2 ________________, #3______________(1 dose if incomplete and >24 mo.)
Polio #0 ________(birth), #1 ____________, #2_____________, #3_____________
Rota #1 ________(6 wk), #2 _____________ (mark unvaccinated if none >8 mo.)
Measles* #1 _________(after 9 mo.), #2 __________(15 mo.) (replace with 2 doses MMR if unvaccinated)
Rubella* #1 _________(after 9 mo.), #2 ___________(15 mo.) (replace with 2 doses MMR if unvaccinated)
The following is the extended immunization plan as recommended by the CDC. These doses or vaccines are not provided by the government and must be purchased through private pharmacies:
DTap #4 ___________ (15-18 mo.) #5 ___________ (4-6 yrs-dose #5 may be skipped if dose #4 given age 4 or older)
PCV #4 ___________ (12 months or 1 dose for incomplete vaccination of healthy children 24-59 mo.)
Polio #4 ____________ (1 dose after 4th birthday)
MMR*+ #1 ____________ (age 12 mo.) #2 ____________ (age 4 yrs or 2nd dose at least 4 weeks after 1st dose)
Varicella*+ #1____________ (age 12 mo.) #2 __________ (age 4 yrs or 3 months after 1st dose)
Men ACWY #1 ________________ (age 11-12 yr) #2 _____________ (16 yrs. If first dose >16 yrs give 1 dose)
(Though Malawi is not in the meningitis belt, we recommend that frequent travelers get Men ACWY at 2 yr of age, repeat every 3 yr until age 7, then repeat every 5 yrs.)
Tdap #1 _______________ (age 11-12 yr)
HPV #1 ___________ (age 9-14 yr) #2 _________(6 mo after 1st dose) #3 ________ (only if >15 yrs first dose)
Men B #1 __________ (age 16 years), #2_________(1 mo. after 1st dose for Bexsero brand; 6 mo. after 1st dose for Trumenba)
(Men B is not recommended for Malawi by CDC unless specific health concerns or at age 16 -Two doses 6 months apart if will be living in dormitory. It is recommended as routine UK immunization schedule at age 8 weeks, age 16 weeks, and age 1 yr.)
Hepatitis A #1 ________________ (age 12 mo.) #2 _____________ (at least 6 months after 1st dose) (Hepatitis A- Babies at age 6 months should get a dose 0 as recommended for travelers)
Rabies #1 _________ (day 0) #2_____________(day 7) #3___________(day 21 or 28) (Rabies– Recommended for children in Malawi for high incidence of rabies. If exposed without immunization medivac for immunoglobulin necessary.) #4________________ (only if possible exposure) #5 ______________ (only if possible exposure)
Typhoid ______________ , ____________, ___________
(Typhoid- recommended for travelers to Malawi by CDC and WHO. Need pills every 5 yrs or injection every 2 yrs. Difficult to find in Malawi.)
Yellow Fever+ _________ (No need in Malawi, but required if traveling from country with yellow fever. May give young as 9 mo. Lifelong immunity.)
Influenza+ ______, _______, _______, ________, ________ (Recommended yearly.)
*These immunizations are to be administered SC route.
+ Should be given on the same day as other live attenuated vaccines or at least 4 weeks apart.
This immunization list was compiled based on the 2019 CDC immunization guidelines and Malawian immunization schedule.
The Malawian immunization schedule is listed at the top. Follow the Malawian baby health book for times if you choose to strictly follow the Malawian plan. Any government immunization site, including ABC Community Clinic, should be keeping vaccines refrigerated and administers immunizations from reliable manufacturers such as GSK, Pfizer, and Serum Institute of India. Malawi is part of GAVI, the vaccine alliance (http://Gavi.org). (Though not yet updated on all of the medical record books, the measles immunization now includes rubella as well, but not mumps. Also, note there is a second dose at 15 months. This is also not updated in some books. You will want to confirm and record MR in the book if that’s what your child receives. I regularly see cases of mumps at the clinic. Please schedule a well-baby appointment if you would like to replace the government provided MR with an immunization you can purchase separately that includes mumps – MMR.)
Because there are many factors (cost, availability, travel, risk, passport country requirements, etc…) included in making an immunization plan for your family, I ask that anyone that is not strictly following the Malawian schedule, do so under the supervision of a trusted healthcare provider.
The rest of the document outlines immunizations recommended by the Centers for Disease Control. You can call ABC Community Clinic to make a well-baby appointment with Dr. Miller if you want to follow the extended immunization plan, using immunizations purchased from private pharmacies as outlined in the rest of the document. For those that were born outside of Malawi and have started immunizations in another country, please make an appointment as well. The government immunization techs are not trained to deviate from the Malawian schedule. I can help develop an immunization plan that will work for you. For appointment Contact
Here is the schedule we use for global kids that want to follow the extended immunization plan according to CDC guidelines. You can print it and keep it with your records:
Note that any immunizations beyond the Malawian government schedule must be administered in passport country or purchased from local pharmacies. Other healthcare providers are welcome to use this schedule for their patients. Anyone using this schedule should do so under the supervision of a healthcare provider.
For more information about the diseases vaccines protect against check out: cdc.gov/vaccines