National Immunization Schedule

Immunisation is one of the primary interventions for protecting children from preventable, life-threatening conditions. Upon seeing its importance, the immunisation programme was started in India in 1978 as the Expanded Programme of Immunisation (EPI). Under UIP, free vaccines are provided against 11 life-threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia and Meningitis due to Haemophilus Influenzae Type B, Measles, Rubella, Japanese Encephalitis (JE), Rotavirus diarrhoea, etc. Any delay in the vaccinations can put your children at needless risk of serious diseases. 

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What is the National Immunisation Schedule 2023?

The Immunisation programme in India was introduced in the year 1978 as the Expanded Programme of Immunisation (EPI). The same was further expanded as the Universal Immunisation Programme seven years later in 1985. Under UIP, free vaccines are provided against 11 life-threatening diseases that are as follows- Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia and Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhoea (Rubella, JE and Rotavirus vaccine in select states and districts).

 

The State Government gives a vaccination schedule to enable a timely national immunisation programme. You should note that a significant delay in vaccination can put children at risk of serious diseases that can easily be prevented. The following National Immunisation Schedule recommended by the Ministry of Health, Government of India is most widely followed by child healthcare providers across the country:

National Immunisation Schedule Chart

Vaccine

When to give

Maximum age

Dose

Route

Site

For Pregnant Women

 

Td -1

early pregnancy

--

0.5ml

Intra-

muscular

Upper arm

Td -2

4 weeks after 1st dose of Td*

--

0.5ml

Intra-

muscular

Upper arm

Td booster

If received 2 Td doses in a pregnancy within the last 3yrs

--

0.5ml

Intra-

muscular

Upper arm

National Immunisation Schedule For Infants

 

BCG

At birth or as early as possible till 1 year of age

At birth till one year

0.1ml (0.05ml until 1month age)

Intradermal

Left Upper Arm

 

Hepatitis B - Birth dose

At birth or as early as possible within 24 hours

At birth within 24 hours

0.5 ml

Intra-

muscular

Antero-lateral side of mid-thigh

OPV -0

At birth or as early as possible within first 15 days

Within the first 15 days

2 drops

Oral

Oral

OPV -1,2,3,

6 weeks, 10 weeks & 14 weeks

Till 5 years of age

2 drops

Oral

Oral

fIPV 1 &2

6 weeks & 14 weeks

1 year of age

0.1 ml

Intradermal

Upper arm

Pentavalent vaccine - 1, 2 & 3**

6 weeks, 10 weeks & 14 weeks

1 year of age

0.5 ml

Intra-

muscular

Antero-lateral side of mid-thigh

RVV 1, 2 & 3

At 6 weeks, 10 weeks & 14 weeks

1 year of age

5 drops

Oral

Oral

PCV 1, 2 & Booster

At 6 weeks, 14 weeks & 9 months

1 year of age

0.5 ml

Intra-

muscular

Antero-lateral side of mid-thigh

MCV 1/ MR 1

9 completed months - to 12 months. Give up to 5yrs if not received at 9 - 12 months age

5 years of age

0.5 ml

Sub-

cutaneous

Right upper arm

Vitamin A (1st dose)

At 9 completed months

5 years of age

1ml (1lakh IU)

Oral

Oral

Japanese Encephalitis (1st Dose)***

At 9 completed months - 12 months

15 years of age

0.5 ml

Sub-

cutaneous

Left Upper Arm

For Children and Adolescents

 

DPT booster 1

16- 24 months

7 years of age

0. 5 ml

Intra- muscular

Antero-lateral side of mid-thigh

MCV 2/ MR 2

16-24 months

5 years of age

0.5 ml

Subcutaneous

Right Upper arm

OPV Booster

16-24 months

5 years of age

2 drops

Oral

Oral

Japanese Encephalitis***(if applicable)

16-24 months

15 years of age

0.5 ml

Sub-

cutaneous

Left Upper Arm

Vitamin A(2nd to 9th dose)

18 months (2nd dose). Then, one dose every 6 months upto the age of 5 years.

5 years of age

2 ml (2 lakh IU)

Oral

Oral

DPT booster

5- 6 years

7 years of age

0.5 ml

Intra-

muscular

Upper arm

Td

10 years &16 years

16 years of age

0.5 ml

Intra-

muscular

Up

* Give Td-2 or Booster doses before 36 weeks of pregnancy. However, give these even if more than 36 weeks have passed. Give Td to a woman in labour if, she has not previously received Td Pentavalent vaccine** (containing Diphtheria+Pertussis+Tetanus+Hepatitis B+Hib).

*** JE vaccine at selected endemic districts.

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Rotavirus vaccine (RVV)

The Under-5 Mortality Rate (U-5MR) in India is 37 for every 1000 births. One of the major causes of this are diarrhoeal deaths, a disease primarily caused by the rotavirus.

Pentavalent Vaccines

Pentavalent vaccines are a combination of DPT (diphtheria, Pertussis/whooping cough and tetanus), Hepatitis B and Hib vaccines. DPT and Hepatitis B vaccines which are already a part of the immunisation programme are being replaced by the pentavalent vaccines in a phased manner. The pentavalent vaccines are administered intramuscularly in doses of 0.5 ml in the mid-thigh region.

 

The revised immunisation schedule, when pentavalent vaccines are introduced, is as follows:

Vaccine

Schedule

BCG, Hep B birth dose, OPV-O

At Birth

Pentavalent (DPT + Hep B + Hib), OPV

6 weeks, 10 weeks and 14 weeks

Measles and Vitamin A

9-12 months

DPT booster, OPV booster, Measles2*

16-24 months

DPT booster

5-6 years

IAP (Indian Academy of Pediatrics) Recommendations

The Indian Academy of Pediatrics which is the largest organisation of paediatricians in India endorses the National Immunisation Schedule. The committee has further supplemented the schedule with the Hepatitis B and the MMR vaccines (Measles, Mumps, & Rubella). Even though Rubella might appear to be a mild illness, it can cause congenital defects in babies if the mother is not protected against Rubella and catches the infection during pregnancy. The schedule is as follows:

Age

Vaccines

Birth

BCG, OPV 0, Hepatitis B -1

6 weeks

IPV-1, DTwP-1, Hepatitis B -2, Hib -1, Rotavirus 1, PCV 1

10 weeks

DTwP-2, IPV 2, Hib -2, Rotavirus 2, PCV 2

14 weeks

DTwP-3 , IPV-3 , Hib -3, Rotavirus 3, PCV 3

6 months

OPV 1, Hep B 3

9 months

OPV 2, MMR-1

9-12 months

Typhoid Conjugate Vaccine

12 months

Hep-A 1

15 months

MMR 2, Varicella 1, PCV Booster

16-18 months

DTwP B 1 / DTaP booster -1, IPV B 1, Hib booster 1

18 months

Hep-A 2

2 years

Booster of Typhoid Conjugate Vaccine

4 - 6 years

DTwP B 2 / DTaP booster -2, OPV 3, MMR 3, Varicella 2,

10 - 12 years

Tdap / Td, HPV (Only for females, three doses at 0, 1-2 and 6 months

 Abbreviations

  • BCG: Bacillus Calmette Guerin

  • OPV: Oral poliovirus vaccine

  • DTwP: Diphtheria, tetanus, whole-cell Pertussis

  • DT: Diphtheria and tetanus toxoids

  • TT: Tetanus toxoid

  • Hep B: Hepatitis B vaccine

  • MMR: Measles, Mumps and Rubella Vaccine

  • Hib: Haemophilus influenzae Type ‘b’ Vaccine

  • IPV: Inactivated Poliovirus Vaccine

  • Td: Tetanus, reduced dose diphtheria toxoid

  • HPV: Human Papillomavirus Vaccine

  • PCV: Pneumococcal Conjugate Vaccine

  • TdaP: Tetanus and Diphtheria Toxoids and a Cellular Pertussis Vaccine

WHO-India Recommendation

The immunisation schedule recommended by the WHO is as follows:

The cross below the age (in weeks) table indicates when the vaccine should be given.

Vaccine

Schedule when the vaccine is to be given

 

Birth

6 weeks

10 weeks

14 weeks

9-12 months

Primary vaccination

BCG Vaccine

X

 

 

 

 

Polio Vaccine

X

X

X

X

 

DTP

 

X

X

X

 

Hepatitis B*

 

X

X

X

 

Rotavirus Vaccine

 

X

X

X

 

Haemophilus influenzae type b

 

X

X

X

 

Pneumococcal (Conjugate)

 

X

X

X

 

Measles

 

 

 

 

X

Rubella

 

 

 

 

X

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FAQs on National Immunization Schedule

  • ✔️What is Immunisation and how does it work ?

    Immunisation is a method of providing artificial immunity against antigens by the means of vaccines. Vaccines stimulate an immune response in the body which results in the formation of antibodies that would fight against diseases if our body encounters the same antigens in the future.

    A person has some innate immunity at birth and gets some natural immunity from the mother and through breastfeeding. However, this is not enough to tackle infectious and potentially fatal diseases. Artificial vaccines help in the prevention of various serious illnesses which could deter a child's development or even result in death.

  • ✔️What are the side effects of vaccinations?

    At rare occasions, vaccination might have some side effects such as pain at the site of injection or a mild fever. The DPT (Diptheria, Pertussis & Tetanus) vaccine shows such side effects while measles-like rashes may develop after the administration of a measles vaccine. Some vaccines might also result in allergic reactions in babies. If a baby develops a high fever or a loss of consciousness upon being vaccinated, a doctor should be immediately consulted. A timely treatment will result in the complete recovery of the child. 

  • ✔️Are there any reasons why a child should not be immunized?

    Common illnesses like colds and diarrhoea are not impediments to getting a child vaccinated. However, there are some conditions where a doctor should be consulted before administering a vaccine. They are enlisted below:

    1. The child has a high fever

    2. S/He has had a bad reaction to another immunization

    3. S/He has had a severe reaction after eating eggs

    4. The child had a convulsion (fits) in the past. (With the right advice, children who have had fits in the past can be immunized)

    5. S/He has had, or is having, treatment for cancer

    6. An illness which affects the immune system, for example, HIV or AIDS

    7. The child is taking a medicine which affects the immune system, for example, immunosuppressants or high-dose steroids.

  • ✔️How do we know that vaccines are safe?

    Vaccines undergo extensive trials and tests to ensure safety. They are made available to the public only after these tests have been successfully conducted and the vaccines are found to be safe. Even after the launch of a vaccine, it is periodically assessed and actions are taken if needed.

  • ✔️Which vaccines can be given to a child between 1-2 years of age, who has never been vaccinated?

    DPT1, OPV-1, Measles and 2ml of Vitamin A solution should be given to the child. The 2nd and 3rd doses of the DPT and OPV vaccine should then be administered at one-month intervals till the child is 2 years of age. Booster doses of the vaccines can be given at a minimum age of 6 months after the OPV3/DPT3 vaccines have been administered.