Recommended Immunization Schedule in India
The Indian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices recommends a comprehensive immunization schedule that includes administration of hepatitis B vaccine within 24 hours of birth, complete replacement of oral polio vaccine by injectable polio vaccine, and specific timing for all essential childhood vaccines to ensure optimal protection against preventable diseases. 1
Birth to 6 Weeks
- Hepatitis B: First dose within 24 hours of birth 1
- For infants born to HBsAg-positive mothers: Administer both hepatitis B vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth 2
- BCG: At birth or as early as possible
6 Weeks
- DTwP/DTaP: First dose 1
- IPV: First dose (preferably) or fractional IPV at government facility 1
- Hepatitis B: Second dose 2
- Hib: First dose (as part of pentavalent vaccine)
- Rotavirus: First dose (can be RV1 at 6 weeks) 1
- Pneumococcal Conjugate Vaccine (PCV): First dose
10 Weeks
- DTwP/DTaP: Second dose
- IPV: Second dose
- Hib: Second dose
- Rotavirus: Second dose (if using RV1 schedule) 1
- PCV: Second dose
14 Weeks
- DTwP/DTaP: Third dose
- IPV: Third dose or at least one dose of intramuscular IPV if not received earlier 1
- Hib: Third dose
- Rotavirus: Third dose (if using three-dose schedule)
- PCV: Third dose
6 Months
- Influenza: First dose (annually for children 6 months to 5 years) 1
- Typhoid Conjugate Vaccine: Single dose from 6 months onwards 1
9 Months
- Measles/MMR/MR: First dose 1
- Typhoid Conjugate Vaccine: Can be administered with MMR vaccine if given at 9 months 1
12-15 Months
- Hepatitis B: Third dose (6-18 months after first dose) 2
- MMR: Second dose (can be given with minimum interval of 4 weeks from first dose)
- Varicella: First dose
- PCV: Booster dose
- Hepatitis A: First dose
16-18 Months
- DTwP/DTaP: First booster
- IPV: Booster
- Hib: Booster
- Hepatitis A: Second dose (6 months after first dose)
4-6 Years
- DTwP/DTaP: Second booster
- MMR/MR: Additional dose during MR campaigns regardless of previous vaccination status 1
- Varicella: Second dose
10-12 Years
- Tdap: Booster
- HPV: Two doses for those who begin series before 15 years (with at least 5 months between doses) 3
- Three doses for those who start after 15 years of age or are immunocompromised
Special Considerations
Influenza Vaccination
- Annual vaccination recommended for all children between 6 months to 5 years of age 1
- Either trivalent or quadrivalent inactivated vaccine can be used
Rabies Vaccination
- Four-dose schedule for post-exposure prophylaxis as recommended by WHO 1
- Monoclonal rabies antibody can be used as alternative to rabies immunoglobulin
Regional Disparities and Coverage
- Full vaccination rates vary significantly across Indian states, from 33.9% in Arunachal Pradesh to 91.3% in Punjab 4
- Children with multiple risk factors (female sex, higher birth order, low maternal education, low family wealth) have lower vaccination rates 4
- Hard-to-reach areas benefit from supplemental immunization activities like Immunization Weeks 5
Important Caveats
- Preterm infants, especially those born before 32 weeks gestation, may need additional doses of pentavalent vaccine for robust immune response 6
- Simultaneous administration of multiple vaccines is safe and effective 3
- Vaccination should not be delayed if the child presents late; catch-up vaccination should be provided according to the recommended schedule
- Always check for contraindications before administering vaccines, including severe allergic reactions to previous doses 7
This schedule represents the current recommendations for India, but individual states may have variations based on local epidemiology and public health priorities.