Although pregnant women are at no greater risk of being infected by SARS-CoV-2, the woman and her infant are more likely to develop complications from COVID-19. Pregnant and lactating women were excluded from initial COVID-19 vaccine trials; thus, data to guide vaccine decision-making are lacking. Clinical trials evaluating the safety and efficacy of COVID-19 vaccines in pregnancy are now underway, and further trials are planned.

As of 27th February 2023, children 5 – 11 years old at risk of severe COVID disease will be eligible to receive two doses of the Comirnaty paediatric Vaccine® given with a minimum interval of 21 days. Children with chronic heart, respiratory, neurological, endocrine, kidney, liver, or gastrointestinal conditions, as well as immunosuppression (including asplenia or dysfunction on the spleen) and serious genetic abnormalities that affect a number of systems, will be eligible and should be offered vaccination. A more detailed list is contained in Annexure A.

The National Essential Medicines List Committee has reviewed the evidence for dolutegravir (DTG)  compared with efavirenz (EFV) in pregnancy, and has determined that the benefits outweigh the risks.

The COVID-19 pandemic disrupted South Africa's health systems and product supply in 2020. Firstline treatment regimens of TEE (tenofovir/ emtricitabine/ efavirenz) and TLD (tenofovir/ lamivudine /dolutegravir) were particularly impacted. Through careful management of suppliers and active stock monitoring under the Affordable Medicine Directorate (AMD) leadership, there are no further supply constraints anticipated in the short to mid-term. The table below highlights healthy stock and pipeline levels, especially for TLD.

Following registration with the South African Health Products Regulatory Authority (SAHPRA), Dolutegravir (DTG) 10mg dispersible, scored tablets are now recommended as part of the standard first-line antiretroviral regimen for children.

The dispersible fixed-dose formulations for the treatment of tuberculosis in paediatrics will be available in the public sector by July 2021. The National Essential Medicines List Committee have approved the following updated weight-banddosing tables for the management of paediatric: A. Uncomplicated pulmonary tuberculosis B. Complicated pulmonary tuberculosis C. Disseminated (Miliary) TB D.