A vaccination schedule is a series of

vaccination Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating ...

s, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. A

vaccine A vaccine is a biological Dosage form, preparation that provides active acquired immunity to a particular infectious disease, infectious or cancer, malignant disease. The safety and effectiveness of vaccines has been widely studied and verifie ...

is an

antigen In immunology, an antigen (Ag) is a molecule or molecular structure or any foreign particulate matter or a pollen grain that can bind to a specific antibody or T-cell receptor. The presence of antigens in the body may trigger an immune response. ...

ic preparation used to produce active immunity to a

disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...

, in order to prevent or reduce the effects of

infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...

by any natural or "wild"

pathogen In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ ...

. Many vaccines require multiple doses for maximum effectiveness, either to produce sufficient initial immune response or to boost response that fades over time. For example, tetanus vaccine boosters are often recommended every 10 years. Vaccine schedules are developed by governmental agencies or physicians groups to achieve maximum effectiveness using required and recommended vaccines for a locality while minimizing the number of health care system interactions. Over the past two decades, the recommended vaccination schedule has grown rapidly and become more complicated as many new vaccines have been developed. Some vaccines are recommended only in certain areas (countries, sub national areas, or at-risk populations) where a disease is common. For instance,

yellow fever Yellow fever is a viral disease of typically short duration. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains – particularly in the back – and headaches. Symptoms typically improve within five days. In ...

vaccination is on the routine vaccine schedule of French Guiana, is recommended in certain regions of Brazil but in the United States is only given to travelers heading to countries with a history of the disease. In developing countries, vaccine recommendations also take into account the level of health care access, the cost of vaccines and issues with vaccine availability and storage. Sample vaccination schedules discussed by the

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...

show a developed country using a schedule which extends over the first five years of a child's life and uses vaccines which cost over $700 including administration costs while a developing country uses a schedule providing vaccines in the first 9 months of life and costing only $25.State of the World's Vaccines and Immunizations (pdf)
from the

(2003 edition) This difference is due to the lower cost of health care, the lower cost of many vaccines provided to developing nations, and that more expensive vaccines, often for less common diseases, are not utilized.

Worldwide

The

monitors vaccination schedules across the world, noting what vaccines are included in each country's program, the coverage rates achieved and various auditing measures. The table below shows the types of vaccines given in example countries. The WHO publishes on its website current vaccination schedules for all WHO member states. Additional vaccines are given to individuals more likely to come into contact with specific diseases through work or travel (e.g. military), or after potentially infectious exposure. Examples include

rabies Rabies is a viral disease that causes encephalitis in humans and other mammals. Early symptoms can include fever and tingling at the site of exposure. These symptoms are followed by one or more of the following symptoms: nausea, vomiting, vi ...

, anthrax,

cholera Cholera is an infection of the small intestine by some strains of the bacterium ''Vibrio cholerae''. Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhea that lasts a few days. Vomiting and ...

and

smallpox Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) c ...

By country

Australia

The Immunise Australia Program implements the National Immunization Program (NIP) Schedule. All vaccines available under the Australian immunization schedule are free of charge under the

Pharmaceutical Benefits Scheme The Pharmaceutical Benefits Scheme (PBS) is a program of the Australian Government that subsidises prescription medication for Australian citizens and permanent residents, as well as international visitors covered by a reciprocal health care ag ...

Austria

Austrian vaccine recommendations are developed by the National Vaccination Board (german: text=Nationales Impfgremium), which is part of the

Federal Ministry of Social Affairs, Health, Care and Consumer Protection In Austrian politics, the Federal Ministry of Social Affairs, Health, Care and Consumer Protection (''Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz'') is the ministry in charge of welfare policy. The Ministry was fi ...

. Children aged 14 and older can be vaccinated without parental consent.

Brazil

All recommended vaccines are provide free of charge by the public health services

Canada

In Canada, publicly funded immunization schedules may vary from province or territory.

Alberta

British Columbia

New Brunswick

Ontario

Quebec

Finland

;History :1960: Mumps vaccinations for military recruits. :1975: Measles vaccination for 1 year old children. :1975: Rubella vaccination for 11–13 years old girls and seronegative mothers. :1982: Two doses of MMR vaccination at 14–18 months and 6 years of age were introduced in the national childhood vaccination programme. :2009: Rotavirus vaccine introduced at 2, 3 and 5 months to all children (September 2009) :2010: PCV introduced at 3, 5 and 12 months of age to all children (September 2010). :2013: HPV vaccination of girls introduced :2017: Varicella vaccination introduced (1 September 2017) at 18 months, 6 years + catch-up of all born from 1 January 2006 or after with no history of varicella. :2020: HPV vaccination of boys introduced

France

Germany

In Germany, a vaccination schedule is developed by the Standing Committee on Vaccination (STIKO), which operates as part of the

Robert Koch Institute The Robert Koch Institute (RKI) is a German federal government agency and research institute responsible for disease control and prevention. It is located in Berlin and Wernigerode. As an upper federal agency, it is subordinate to the Federa ...

. The recommendations are generally adopted by the Federal Joint Committee.

Hong Kong

In Hong Kong,

Department of Health A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their ow ...

is responsible for providing free vaccinations from newborns up to primary school students.

India

In India, the standard vaccination schedule is recommended by the Indian Academy of Paediatrics(IAP). The latest schedule was the one given in 2016.

Italy

Japan

The vaccination schedule in Japan is defined and partially recommended by () and its related (). By the combined laws, infections are categorized into two groups: Category A is recommended for vaccination to prevent pandemic whereas Category B is only for a personal care purpose. As of January 2020, fourteen infections are Category A diseases and two are Category B on the legal lists. The Act and the Order were enacted for mandatory vaccination in 1948 with punitive clauses, only the clauses were repealed in 1976 and eventually vaccination has become non-mandatory since 1994.

Only in the legal term in Japan, citizens get old one day before their birthdays. If a person was born on January 1, 2020, and Immunization Act specifies vaccine against measles could be received from age 12 months to 24 months, vaccination shall be practiced between December 31, 2020, and December 31, 2021 (not between January 2021 and January 2022.) Some vaccinations are scheduled in line with the school year system, which starts from April 1 in Japan. As explained, those who born on April 1 and on April 2 get old legally on March 31 and April 1, respectively. Thus, these two people are in different school years and thereby they may take vaccines in different calendar years.

New Zealand

;History Major additions, replacements and removals from the New Zealand Immunization Schedule include: :1958: First Schedule: DTwP and DT :1961: Polio (OPV) added :1971: Measles, rubella and tetanus toxoid added :1979: Rubella changed to girls only :1988: HepB added :1990: MMR replaced measles and rubella :1994: HIB added; Td replaced tetanus toxoid :1996: DT dropped :1997: Influenza added :2000: DTaP replaced DTwP :2002: IPV replaced OPV :2006:

MeNZB MeNZB was a vaccine against a specific strain of group B meningococcus, used to control an epidemic of meningococcal disease in New Zealand. Most people are able to carry the meningococcus bacteria safely with no ill effects. However, meningoco ...

and Tdap added :2008: MeNZB dropped, PCV7 added, HPV4 added for females only :2011: PCV10 replaced PCV7 :2014: RV5 added, PCV13 replaced PCV10 :2017: HPV9 replaced HPV4 and extended to males, RV1 replaced RV5, PCV10 replaced PCV13, VV added. :2018: HZ added. :2020: Td dropped.

Nigeria

All recommended vaccines are provide free of charge by the Federal Ministry of Health.

Spain

United Kingdom

The United Kingdom childhood vaccination schedule is recommended by the Department of Health and

National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...

, and uses combination immunisations where available.

Non-routine vaccinations

Some children may receive vaccines in addition to those listed in the table: *

BCG vaccine Bacillus Calmette–Guérin (BCG) vaccine is a vaccine primarily used against tuberculosis (TB). It is named after its inventors Albert Calmette and Camille Guérin. In countries where tuberculosis or leprosy is common, one dose is recommended ...

is given at birth to "children born in areas of the country where there are high numbers of TB cases" and "children whose parents or grandparents were born in a country with many cases of TB." *

Hepatitis B vaccine Hepatitis B vaccine is a vaccine that prevents hepatitis B. The first dose is recommended within 24 hours of birth with either two or three more doses given after that. This includes those with poor immune function such as from HIV/AIDS and th ...

is given at birth to "babies born to mothers who have hepatitis B". * The injected flu vaccine is offered annually to "children 6 months to 17 years old with long-term health conditions".

Adult vaccinations

The five scheduled childhood tetanus vaccinations are thought to generally confer lifelong immunity; thus, no routine

booster dose A booster dose is an extra administration of a vaccine after an earlier (primer) dose. After initial immunization, a booster provides a re-exposure to the immunizing antigen. It is intended to increase immunity against that antigen back to protec ...

s are given in adulthood. Those adults at risk of contaminated cuts (e.g., gardeners) may have booster tetanus vaccination every ten years.

Pneumococcus ''Streptococcus pneumoniae'', or pneumococcus, is a Gram-positive, spherical bacteria, alpha-hemolytic (under aerobic conditions) or beta-hemolytic (under anaerobic conditions), aerotolerant anaerobic member of the genus Streptococcus. They are ...

vaccinations (pneumococcal polysaccharide vaccine/PPV) are recommended for those over 65 and for people without a functional spleen (

asplenia Asplenia refers to the absence of normal spleen function and is associated with some serious infection risks. Hyposplenism is used to describe reduced ('hypo-') splenic functioning, but not as severely affected as with asplenism. ''Functional'' a ...

), either because the spleen has been removed or does not work properly.

Flu vaccine Influenza vaccines, also known as flu shots, are vaccines that protect against infection by influenza viruses. New versions of the vaccines are developed twice a year, as the influenza virus rapidly changes. While their effectiveness varies fr ...

is recommended for anyone who is aged 65 years and over, people with certain long-term medical conditions, health and social care professionals, pregnant women, and

poultry Poultry () are domesticated birds kept by humans for their eggs, their meat or their feathers. These birds are most typically members of the superorder Galloanserae (fowl), especially the order Galliformes (which includes chickens, quails, a ...

workers. The shingles vaccine is recommended for those over 70. Additionally, pregnant women are advised to have the pertussis vaccine.

United States

The most up-to-date schedules are available from CDC's

National Center for Immunization and Respiratory Diseases The National Center for Immunization and Respiratory Diseases (NCIRD), formerly known as the National Immunization Program until April 2006, is charged with responsibility for the planning, coordination, and conduct of immunization activities in ...

. In the US, the

National Childhood Vaccine Injury Act The National Childhood Vaccine Injury Act (NCVIA) of 1986 (42 U.S.C. §§ 300aa-1 to 300aa-34) was signed into law by United States President Ronald Reagan as part of a larger health bill on November 14, 1986. NCVIA's purpose was to eliminate t ...

requires all health-care providers to provide parents or patients with copies of Vaccine Information Statements before administering vaccines.

During pregnancy

The CDC recommends pregnant women receive some vaccines, such as the measles, mumps, rubella (MMR) vaccine a month or more before pregnancy. The Tdap vaccine (to help protect against whooping cough) is recommended during pregnancy. Other vaccines, like the flu shot, can be given before or during pregnancy, depending on whether or not it is flu season. Vaccination is safe right after giving birth, even while breastfeeding.

History

In 1900, the

smallpox vaccine The smallpox vaccine is the first vaccine to be developed against a contagious disease. In 1796, British physician Edward Jenner demonstrated that an infection with the relatively mild cowpox virus conferred immunity against the deadly smallpox ...

was the only one administered to children. By the early 1950s, children routinely received three vaccines, for protection against

diphtheria Diphtheria is an infection caused by the bacterium '' Corynebacterium diphtheriae''. Most infections are asymptomatic or have a mild clinical course, but in some outbreaks more than 10% of those diagnosed with the disease may die. Signs and s ...

pertussis Whooping cough, also known as pertussis or the 100-day cough, is a highly contagious bacterial disease. Initial symptoms are usually similar to those of the common cold with a runny nose, fever, and mild cough, but these are followed by two or t ...

tetanus Tetanus, also known as lockjaw, is a bacterial infection caused by ''Clostridium tetani'', and is characterized by muscle spasms. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. Each spasm usually ...

, and

, and as many as five shots by two years of age. Since the mid-1980s, many vaccines have been added to the schedule. In 2009, the U.S. Centers for Disease Control and Prevention (CDC) recommended

against at least fourteen diseases. By two years of age, U.S. children receive as many as 24 vaccine injections, and might receive up to five shots during one visit to the doctor. The use of combination vaccine products means that, , the United Kingdom's immunization program consists of nine injections by the age of two, rather than 22 if vaccination for each disease was given as a separate injection.

References

External links

* International ** ** UN

: * Europe *
Vaccine schedules in all countries of the European Union

European Centre for Disease Prevention and Control The European Centre for Disease Prevention and Control (ECDC) is an agency of the European Union (EU) whose mission is to strengthen Europe's defences against infectious diseases. It covers a wide spectrum of activities, such as: surveillance, ...

** United Kingdom *** * USA ** *
CDC 2013 Recommended Immunizations for Children from Birth Through 6 Years Old
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