Why Vaccinating Your Child on Time Matters: India's Immunisation Schedule Explained

Vaccination is one of the most effective tools we have to protect children from serious, potentially life-threatening diseases. As a paediatrician with over 40 years of experience, I have seen both the damage these diseases can cause and the remarkable difference timely vaccination makes. Some parents are unsure about which vaccines their child needs, when they should be given, and whether they are truly necessary. This post answers those questions clearly.

Why is vaccination so important for children in India?

India has a unique disease landscape. Diseases like typhoid, hepatitis A, rotavirus diarrhoea, and Japanese encephalitis are far more common here than in Western countries. Our climate, population density, and water supply patterns mean Indian children are at a significantly higher risk of exposure.

As a result of a strong national vaccination programme . India was officially declared polio-free by the World Health Organisation in March 2014 .Before the rotavirus vaccine was introduced into India's programme, rotavirus diarrhoea was one of the leading causes of death in children under 5. Vaccines work. The evidence is clear and consistent.

What is the IAP immunisation schedule?

The Indian Academy of Pediatrics (IAP) publishes an updated vaccination schedule every year. This is the gold standard recommended by paediatricians across the country. It is broader than the government's Universal Immunisation Programme (UIP) and is designed to protect children against more than 20 serious diseases.

India's Universal Immunisation Programme (UIP) provides several core vaccines completely free of cost at government health centres. These include BCG, Oral Polio Vaccine, Hepatitis B, DPT (Diphtheria, Pertussis, Tetanus), and MMR (Measles, Mumps, Rubella). Vaccines not included in the UIP — such as the Varicella (chickenpox), Typhoid Conjugate, and HPV vaccines — are available at private clinics.

Which vaccines does my child need and when?

The following is a simplified overview of the key vaccines in the IAP schedule:

At Birth: BCG (for tuberculosis), Hepatitis B (first dose), and Oral Polio Vaccine (OPV zero dose).

6 Weeks: DTwP or DTaP (Diphtheria, Tetanus, Pertussis), IPV (Injectable Polio Vaccine), Hib (Haemophilus influenzae type B), Hepatitis B (second dose), Rotavirus (first dose), and PCV (Pneumococcal Conjugate Vaccine — first dose).

10 Weeks and 14 Weeks: Second and third doses of DTwP/DTaP, IPV, Hib, Rotavirus, and PCV. Hepatitis B third dose at 14 weeks.

6 Months: Influenza vaccine (first dose, then annually), and Typhoid Conjugate Vaccine (TCV — first dose).

9 Months: MMR first dose (Measles, Mumps, Rubella) and OPV booster.

12 Months: Hepatitis A (first dose) and Varicella (chickenpox) first dose.

15–18 Months: Booster doses of DTwP/DTaP, IPV, Hib, and PCV. MMR second dose. Varicella second dose. Hepatitis A second dose.

4–6 Years: DTwP/DTaP booster, OPV booster, and MMR third dose.

9–15 Years (Girls and Boys): HPV vaccine — now recommended for both girls and boys by IAP to prevent cancers caused by the Human Papillomavirus.

10–12 Years and 16–18 Years: Tdap or Td booster doses.

Please note this is a simplified overview. Your paediatrician will give you a personalised schedule card based on your child's exact date of birth and any vaccines already received.

What is the difference between the government UIP vaccines and the IAP schedule?

The government's Universal Immunisation Programme provides excellent basic coverage and is available completely free at government hospitals and primary health centres across India. The IAP schedule adds additional vaccines — such as PCV (for pneumonia), Hepatitis A, Varicella, Typhoid Conjugate, and HPV — which are recommended based on India's disease patterns but are currently available only at private clinics.

At Dr Nakras Clinic, we follow the IAP recommended schedule and can guide you on which vaccines are available under the government programme and which need to be obtained privately.

Does it matter if we delay a vaccine by a few weeks?

Yes, timing matters. Vaccines are scheduled at specific ages because a child's immune system is most responsive at certain points in development. More importantly, the early weeks and months of life are when children are most vulnerable to infections like whooping cough (pertussis) and Haemophilus influenzae, which can be severe and even fatal in young infants.

Delaying vaccines — even by a few weeks — leaves a window of vulnerability. Parents are encouraged to get their babies as scheduled.

Are vaccines safe? What about side effects?

All vaccines on the IAP and government schedules have undergone extensive clinical testing and are approved by India's Central Drugs Standard Control Organisation (CDSCO). They are safe for healthy children.

Some children experience mild side effects after vaccination, including:

• Low-grade fever for 1–2 days

• Redness or swelling at the injection site

• Mild fussiness or crying

These reactions are normal and indicate that the immune system is responding. They typically resolve within 24–48 hours. Serious allergic reactions to vaccines are extremely rare — occurring in roughly 1–2 per million doses — and clinics are equipped to manage them immediately.

If your child develops a high fever above 39°C, persistent crying for more than 3 hours, or any swelling beyond the injection site, please contact your paediatrician.

My child missed some vaccines. Is it too late?

It is never too late to vaccinate. The IAP provides a catch-up schedule for children who have missed doses. You do not need to restart the series from the beginning — in most cases, your paediatrician will simply continue from where you left off.

If your child has missed vaccines, bring their vaccination card to their next appointment and we can assess what is needed and create a plan to get them fully protected.

What is herd immunity and why does it matter in India?

Herd immunity — also called community immunity — occurs when enough people in a community are vaccinated that the disease can no longer spread easily. This protects those who cannot be vaccinated, including newborns too young for certain vaccines, elderly grandparents, and children with certain medical conditions.

In densely populated urban areas like Delhi, herd immunity is particularly important. When vaccination rates drop in a community, even partially, diseases that were under control — like measles — can return rapidly. We have seen measles outbreaks in parts of India in recent years precisely for this reason.

Vaccinating your child is not only about protecting your own child. It is also an act of responsibility towards your neighbourhood and community.

Vaccination is not a choice between risk and safety. It is a choice between a small, manageable risk and a much larger, very real one.

If you have any concerns about your child's vaccination schedule, missed doses, or any specific vaccine, I am always happy to discuss them at your next appointment.