Your Health in South Africa: Immunizations, Diseases, and Medication

To follow up with Top Five Ways to Prepare for your Health in South Africa, I wanted to shed some light on which immunizations you need in South Africa, as well as the availability of over the counter (OTC) medications.

Immunizations Needed for South Africa

Everyone in your family should be up to date on routine immunizations. The Centers for Disease Control and Prevention (CDC) recommends the following routine childhood vaccines for everyone in the United States:

  • Hepatitis B
  • Rotavirus
  • DTaP
  • Hib
  • Pneumococcal
  • Polio
  • Flu
  • MMR
  • Chickenpox
  • Hepatitis A
  • Meningococcal
  • HPV

While your children might be current, you yourself might not be, since some of these vaccines were not routine in the past. Particularly the hepatitis A vaccine is highly recommended for South Africa.

A note about the flu shot: It was our experience – and that of other expats I’ve spoken to – that the flu isn’t as much of a factor in South Africa. This may have to do with the climate: When the typical “flu season” is in full swing during the North American and European winter months, it is summer in South Africa, meaning people are not confined to the indoors. Also, living mostly without central heat or air conditioning might further prevent the spread of germs. Our South African doctors never mentioned flu shots, and as a result we more or less forgot about them, without any repercussions. However, they are certainly available should you want them.

In addition to your routine vaccines, the CDC recommends another one specifically for South Africa:

  • Typhoid

CDC recommends this vaccine for “most travelers, especially if you are staying with friends or relatives, visiting smaller cities or rural areas, or if you are an adventurous eater.” I will say that no one in our family ever contracted typhoid while living in South Africa without the vaccine, although we were adventurous eaters (impala poop, anyone?) and went on the occasional safari in rural areas.

By the way, since typhoid is a waterborne disease, I’d like to point out again that the drinking water in South Africa is absolutely safe. In fact, I have seldom tasted better tap water.

Finally, the CDC mentions three more diseases for “some travelers” to beware of in South Africa:

  • Malaria
  • Rabies
  • Yellow Fever

Let’s talk about these before you rush to see your doctor.

Malaria only occurs in areas bordering Zimbabwe and Mozambique, and even there the risk of contracting it is low. The rest of South Africa is malaria-free. If you travel to Kruger Park from October to March, you should see a South African doctor for a Malanil (or comparable) prescription. Don’t ask your European or American doctor for one before you move, as they are not as knowledgeable. (Also, malaria prophylaxis is cheaper in South Africa.)

The CDC recommends a rabies vaccine for anyone moving to South Africa or staying a prolonged time, especially for people involved in outdoor activities or working with animals. I would say that unless you are moving to a rural area where you’re likely to be in contact with animals, there is no bigger risk of rabies in South Africa than anywhere in America. I want to mention, however, that a child of a friend of ours was bitten by a small animal she was trying to pet while on safari, and she had to undergo the entire rabies post-bite regimen of shots as a precaution. To avoid that, and to be absolutely safe, you might consider rabies vaccines for your family.

There is no risk of Yellow Fever in South Africa. You will not need an immunization prior to moving. However, if you plan to travel to a yellow fever risk area, you will need an immunization and the corresponding certificate to get back into South Africa. Like malaria prophylaxis, yellow fever vaccines and certificates are a matter of routine for South Africa doctors.

Over The Counter Medications in South Africa



Not being able to buy certain over the counter (OTC) medicines in your new country of residence is a common concern among expats. However, the opposite can also be true – finding medicines you were previously unable to get without prescription. Based on a short reader survey, I’ve grouped the most common drugs by their availability in the United States versus South Africa (sorry, Europe and Asia).

1. Drugs available OTC in South Africa that are prescription-only in the USA:

Codeine can be found in South African OTC painkillers such as Nurofen Plus, Myprodol, Panado (also Panadol), or Sinutab. If you suffer from sinus headaches, codeine can be very effective. Then again perhaps you won’t need it – a reader says her sinus headaches came on less often in South Africa than before. I’ve told you Johannesburg has a great climate!

Other drugs available OTC in South Africa but not the United States are birth control pills, diclofenac (Voltaren) and bronchodilators like albuterol (Ventolin) to treat breathing problems such as asthma.

(Note that in South Africa these drugs literally are “over” the counter; rather than displayed on the shelf ready for the taking, they are stashed away behind the pharmacy counter and need to be asked for – sometimes in exchange for your personal data.)

2. Drugs available OTC in both South Africa and the USA:

Most American OTC painkillers are available in South Africa, but they often have different names and usually don’t come in large quantities. South African pharmacies are required to offer the generic alternative to brand name drugs, so it helps to know your active ingredients.

A quick translation of painkiller ingredients and brand names:

Acetaminophen (Tylenol) = Paracetamol, Panado
Ibuprofen (Motrin, Advil) = Nurofen
Acetylsalicylic acid (Aspirin) = Disprin

Some brands combine several of these ingredients into one, such as Anadin (Aspirin and paracetamol with caffeine) or the aforementioned painkillers containing codeine.

EpiPens, according to another reader, are often prone to shortages or too-short expiration dates in South Africa. You might be better advised putting those on your “buy before moving to South Africa” list.

3. Drugs available OTC in the USA that are prescription-only in South Africa:

One reader shared that progesterone cream is not available OTC in South Africa. Neither is Melatonin, a drug to prevent jet lag.

Another reader couldn’t find Abbott Synthroid to treat hypothyroidism. The European alternative Euthyrox apparently made for a good substitute.

Yet another reader wanted plain old diphenhydramine (Benadryl) and was told that as an “old generation” drug it was not available in South Africa, not even as a prescription. Her doctor prescribed Cetirizine (Ceticit or Zyrtex, which is available OTC in the USA), but she maintains that it didn’t “cut it” to alleviate severe allergic reactions to mosquito bites.

I hope you’ve found this information useful in planning your move to South Africa. In addition to possibly stocking up on drugs you won’t be able to easily source, make sure you have a health insurance plan that covers prescription drugs wherever you travel. I recommend Cigna with its encompassing coverage and services tailored to expats. Click here to see the full range of Cigna Africa services.

This post was sponsored by Cigna. Opinions expressed are entirely my own, unless quoted from 3rd party websites such as the CDC.

Share this: