India's National Immunisation Schedule: an overview for parents
Vaccination is one of the most powerful and proven ways to protect a baby from serious illness in the first two years of life. India's Universal Immunisation Programme (UIP) provides a structured schedule of free vaccines from birth through early childhood, coordinated by the Ministry of Health and Family Welfare. Understanding which vaccines are given, why they matter, and what to expect at each visit helps parents feel prepared and confident at every appointment. This article provides a clear, parent-friendly overview of the National Immunisation Schedule (NIS) for babies from birth to 24 months.
A note on Cubby: Cubby does not currently track the NIS schedule in-app. You can use Cubby to log observations and growth measurements after each vaccination visit so you always have an accurate record of what happened and when.
What is the National Immunisation Schedule?
The National Immunisation Schedule is the official government-recommended timetable of vaccines for children in the first years of life. It is delivered under the Universal Immunisation Programme, one of the largest public health programmes in the world. The UIP offers free vaccines through a network of government hospitals, community health centres, primary health centres, sub-centres, and anganwadis across the country.
The schedule is based on scientific guidance about when a baby's immune system is best able to respond to each vaccine and when the risk from particular diseases is highest. Following the schedule as closely as possible gives babies the best protection at the right time. Private paediatricians may offer additional vaccines not included in the government schedule, such as rotavirus, pneumococcal, and varicella vaccines. Speak to your doctor about what additional protection makes sense for your child.
Why vaccination matters in the first year
Newborns receive some immunity from their mother through the placenta and through breastfeeding, but this protection is partial and fades over the first months of life. Vaccines help the immune system build its own lasting defences against diseases that can be severe or life-threatening in young babies. Polio, measles, hepatitis B, diphtheria, whooping cough (pertussis), tetanus, and tuberculosis are all conditions that vaccines protect against, and all of them can cause serious harm or death in unvaccinated infants.
When a large proportion of a community is vaccinated, the spread of disease slows for everyone, including babies too young or too unwell to be vaccinated themselves. Keeping your baby's vaccines up to date is therefore not only about protecting your own child but also about protecting vulnerable people around them.
Vaccines at birth
Three vaccines are recommended as close to birth as possible, ideally before the baby leaves the birthing facility.
- BCG (Bacillus Calmette-Guerin): This vaccine protects against tuberculosis, particularly the severe forms that affect young children, including TB meningitis. It is given as a single injection, usually in the upper left arm. A small raised bump may appear at the injection site and can take several weeks to heal, leaving a small scar. This is normal and expected.
- OPV 0 (Oral Polio Vaccine, birth dose): Polio is a viral disease that can cause permanent paralysis. OPV is given as drops by mouth rather than an injection and provides protection against all three strains of poliovirus. The birth dose primes the immune system before the primary series begins at six weeks.
- Hepatitis B (birth dose): Hepatitis B is a viral liver infection that can become chronic if acquired in infancy and can lead to liver disease in adulthood. The birth dose is most effective when given within 24 hours of birth, before any potential exposure from the mother.
Vaccines at 6 weeks
The six-week visit is the first of three closely spaced visits that together build the primary course of protection.
- OPV 1: First dose of the primary oral polio series, following the birth dose.
- Pentavalent 1 (DPT + Hib + Hepatitis B): The pentavalent vaccine is a combination vaccine that protects against five diseases in a single injection: diphtheria, pertussis (whooping cough), tetanus, Haemophilus influenzae type b (Hib), and hepatitis B. Diphtheria and pertussis are highly contagious respiratory infections that are particularly dangerous in young babies. Tetanus can enter the body through wounds. Hib bacteria cause meningitis and pneumonia. Receiving all five components together is both convenient and effective.
- Fractional IPV 1 (Inactivated Polio Vaccine): An injected polio vaccine that complements the oral drops by building immune responses at a different site in the body, offering broader protection.
- Rotavirus 1: Rotavirus is the most common cause of severe diarrhoea and dehydration in infants and young children globally. The oral rotavirus vaccine reduces the risk of severe illness significantly. (Note: rotavirus vaccine availability may vary by state under the UIP; confirm with your health centre.)
Vaccines at 10 weeks
The ten-week visit continues the primary series started at six weeks.
- OPV 2: Second dose of the primary oral polio series.
- Pentavalent 2: Second dose of the combination vaccine covering diphtheria, pertussis, tetanus, Hib, and hepatitis B.
- Rotavirus 2: Second dose of the oral rotavirus vaccine (where available under UIP).
Vaccines at 14 weeks
The fourteen-week visit completes the primary series and adds further polio protection.
- OPV 3: Third and final dose of the primary oral polio series.
- Pentavalent 3: Third dose of the combination vaccine. After this dose, the primary course for diphtheria, pertussis, tetanus, Hib, and hepatitis B is complete.
- Fractional IPV 2: Second fractional dose of the injected polio vaccine.
- Rotavirus 3: Third dose of the oral rotavirus vaccine (where available under UIP).
Vaccines at 9 months
After the intensive primary schedule in the first few months, there is a gap before the nine-month visit, which introduces protection against two additional diseases.
- Measles and Rubella 1 (MR 1): The MR vaccine protects against measles and rubella. Measles is highly contagious and can cause severe complications including pneumonia, encephalitis, and death. Rubella in early pregnancy can cause serious birth defects. The vaccine is given as an injection.
- JE 1 (Japanese Encephalitis, first dose): Japanese Encephalitis is a viral brain infection spread by mosquitoes. JE vaccine is part of the schedule in endemic districts across specific states. If you live in or travel to an endemic area, ask your health centre whether your baby needs this vaccine.
- Vitamin A supplement (first dose): While not a vaccine, Vitamin A supplementation starts at nine months. Vitamin A deficiency is a major cause of preventable childhood blindness and increases the risk of severe infections. The supplement is given as a single oral dose of 1 lakh IU.
Vaccines at 16 to 24 months
Between 16 and 24 months, booster doses reinforce the protection built by the primary series.
- DPT Booster 1: A booster dose of diphtheria, pertussis, and tetanus. Booster doses are needed because the immunity from the primary series fades over time.
- OPV Booster: A booster dose of oral polio vaccine.
- Measles and Rubella 2 (MR 2): The second dose of the MR vaccine to ensure durable, long-lasting protection. Some children do not respond fully to the first dose, and this second dose catches those who did not.
- JE 2 (Japanese Encephalitis, second dose): Second dose for children in endemic areas.
- Vitamin A supplement (second dose): The second six-monthly dose of Vitamin A, 2 lakh IU.
How vaccines protect your baby
Vaccines work by introducing the immune system to a weakened, killed, or partial version of a pathogen. This teaches the immune system to recognise the pathogen and produce antibodies against it, without causing the disease itself. If the baby later encounters the real pathogen, the immune system can respond quickly and powerfully, preventing illness or significantly reducing its severity.
Some vaccines, such as pentavalent and IPV, are given as injections into the muscle of the thigh. Others, such as OPV and rotavirus, are given as oral drops. The method of delivery is chosen to produce the best immune response for that particular disease.
It is completely normal for a baby to receive several vaccines in a single visit. The immune system is capable of responding to many antigens at once, and combination vaccines have been specifically designed so that the components do not interfere with one another's effectiveness.
What to expect after vaccination
Mild reactions after vaccination are common and are a sign that the immune system is responding. These typically include:
- Redness, swelling, or tenderness at the injection site, which usually settles within a few days
- A mild fever, which is more common after some vaccines than others
- Irritability, fussiness, or crying for a few hours after the visit
- Sleepiness or reduced appetite for a day or two
Paracetamol drops at the appropriate dose for your baby's weight can help with mild fever or discomfort. Ask your paediatrician or pharmacist for guidance on dosing. Serious allergic reactions to vaccines are very rare but can occur, which is why health workers ask you to wait at the health centre for 15 to 30 minutes after each injection. If you notice signs of a severe reaction, including difficulty breathing, swelling of the face or throat, or a sudden rash across the body, seek medical help immediately.
Keeping records and staying on schedule
Every time your baby receives a vaccine under the UIP, the date and dose should be recorded in your child's immunisation card. Keep this card safe, as it is a permanent record that will be requested by schools, childcare providers, and doctors throughout your child's life. If the card is lost, contact the health centre where the vaccines were given to obtain a replacement record.
Timing matters. The NIS schedule is designed around specific ages because that is when the immune system is best primed to respond and when risk from disease is highest. Aim to attend each appointment as close to the scheduled age as possible. If you miss a date, do not wait until the next scheduled visit: contact your health centre to book a catch-up appointment. You do not need to restart a series from the beginning if doses are delayed, but the gap between doses should not be extended beyond what is recommended.
Cubby does not currently track the NIS schedule in-app. However, you can use Cubby to log notes and observations after each vaccination visit, record your baby's growth and weight checks, and keep a clear timeline of your baby's health history in one place.
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Start freeVaccines outside the NIS
The government schedule covers the most critical vaccines for the broadest population. Private paediatricians often recommend additional vaccines that are not currently part of the UIP, including:
- Pneumococcal conjugate vaccine (PCV): Protects against pneumococcal bacteria, a leading cause of pneumonia, meningitis, and ear infections in young children.
- Varicella (chickenpox) vaccine: Protects against a common but sometimes complicated childhood illness.
- Hepatitis A vaccine: Protects against hepatitis A, which is more common in areas with lower sanitation.
- Influenza vaccine: Annual flu shots are recommended by some paediatricians from six months onwards.
- Meningococcal vaccine: Protection against bacterial meningitis.
These vaccines involve out-of-pocket costs at private clinics. Discuss the options with your paediatrician, who can advise which additional vaccines make sense for your baby based on your location, family health history, and circumstances.
Addressing common concerns
Many parents have questions or concerns about vaccines. Here are some of the most frequently raised points, addressed with evidence-based information.
Do multiple vaccines at once overwhelm the immune system?
This is a common worry, but studies consistently show that the immune system handles multiple vaccines simultaneously without being overwhelmed. A baby's immune system responds to thousands of environmental antigens every day. The antigens in a full set of vaccines are a tiny fraction of what the immune system manages routinely. Combination vaccines are specifically tested and approved for co-administration.
My baby had a fever after the last vaccine. Should I skip the next dose?
A mild fever after vaccination is expected and is not a reason to skip or delay the next dose. If your baby had a severe reaction to a previous dose, speak to your doctor before the next scheduled vaccination so they can assess the situation. Most babies who experience mild reactions can and should continue with the schedule.
Are herbal or traditional remedies a substitute for vaccines?
No. While some traditional practices are believed to support general health, there is no herbal or traditional remedy with clinical evidence of protection equivalent to vaccines against diseases such as polio, measles, or diphtheria. These diseases can cause severe harm in unvaccinated infants regardless of other health practices.
What if my baby is unwell on the day of a scheduled vaccine?
A mild cold or low-grade temperature is generally not a reason to postpone vaccination. A seriously unwell baby, or one with a high fever, may need to wait until they have recovered. Your health centre or doctor will assess the situation on the day and advise accordingly.
Frequently asked questions
What vaccines does a baby get at birth under the NIS?
At birth, babies receive BCG (for tuberculosis protection), the first dose of OPV (oral polio vaccine), and the first dose of the Hepatitis B vaccine. These are given at the birthing facility before discharge where possible.
Is the NIS vaccination schedule free of charge?
Yes. All vaccines included in the National Immunisation Schedule are provided free of cost at government health centres, sub-centres, and anganwadis under the Universal Immunisation Programme.
What should I do if my baby misses a scheduled vaccine dose?
A missed dose does not mean starting the series over. Contact your nearest government health centre or private paediatrician as soon as possible to arrange a catch-up appointment. Most vaccines can be given later, and a paediatrician can advise on the correct interval.
Does Cubby track the NIS schedule in the app?
Cubby does not currently track the NIS schedule in-app. You can use Cubby to log observations and growth measurements after vaccination visits so you have an accurate, timestamped record of your baby's health history.
Sources
- National Health Portal of India, Immunization
- Ministry of Health and Family Welfare, Government of India
- National Health Mission, Universal Immunisation Programme