A mother in Sitapur brings her three-month-old to the government health centre. The ANM gives a small injection and a few drops of liquid into the baby's mouth. The whole thing takes five minutes. The mother doesn't know exactly what disease was just prevented — but that prevention, repeated on schedule over the next two years, is one of the most powerful things medicine has ever given humanity.
Vaccines work best when they are given at the right time, in the right order, without missing doses. And in India, every single vaccine in the national immunization schedule is completely free at any government health centre, sub-centre, or anganwadi. No prescription needed. No insurance needed. Walk in.
And yet, data from the National Family Health Survey (NFHS-5) shows that only 76.1% of children aged 12-23 months are fully immunized in India. Nearly one in four children is either unvaccinated or partially vaccinated — leaving them exposed to diseases like measles, whooping cough, and hepatitis B that can kill or permanently disable them.
This guide is for every parent, grandparent, and family member who has ever been unsure about which vaccine is due, when, why, and what to do if a dose has been missed.
Understanding India's Universal Immunization Programme (UIP)
The UIP is one of the largest public health programmes in the world. Launched in 1985 and expanded continuously since, it provides free vaccines to every child born in India and every pregnant woman, through a network of over 90,000 vaccine delivery sites — including primary health centres (PHCs), community health centres (CHCs), anganwadis, and outreach sessions run by ANMs (Auxiliary Nurse Midwives) in rural areas.
Who is entitled to free vaccines
- Every child born in India — from birth through age 16
- Every pregnant woman — for tetanus/diphtheria protection
- No means test, no Aadhar requirement to receive vaccines (though Aadhar helps for record-keeping in eVIN)
The national vaccine schedule is set by the Ministry of Health and Family Welfare based on Indian Academy of Pediatrics (IAP) guidance and WHO recommendations.
The Complete Vaccination Schedule — Age by Age
At Birth (within 24 hours)
| Vaccine | Disease Prevented | How Given |
|---------|-----------------|-----------|
| BCG | Tuberculosis (severe childhood TB, TB meningitis) | Injection in left upper arm |
| OPV-0 (Oral Polio Vaccine) | Polio | Oral drops |
| Hepatitis B — Birth dose | Hepatitis B liver infection | Injection in thigh |
Why the Hepatitis B birth dose must be within 24 hours: Hepatitis B can be transmitted from mother to child during delivery. The birth dose, given within 24 hours of delivery, is up to 95% effective at preventing this transmission. If given later, effectiveness drops significantly. If your delivery happens in a government hospital, this should happen automatically — but confirm with the nurse.
At 6 Weeks (1.5 months)
| Vaccine | Disease Prevented |
|---------|-----------------|
| OPV-1 | Polio |
| Pentavalent-1 (DPT + Hepatitis B + Hib) | Diphtheria, Whooping Cough (Pertussis), Tetanus, Hepatitis B, Meningitis |
| Rotavirus Vaccine (RVV-1) | Rotavirus diarrhoea (a leading cause of child death in India) |
| IPV-1 (Injectable Polio Vaccine) | Polio (additional protection) |
| PCV-1 (Pneumococcal Vaccine) | Pneumonia, Meningitis caused by Streptococcus pneumoniae |
| fIPV-1 (fractional IPV) | Polio (in some states) |
At 10 Weeks (2.5 months)
| Vaccine | Disease Prevented |
|---------|-----------------|
| OPV-2 | Polio |
| Pentavalent-2 | Diphtheria, Whooping Cough, Tetanus, Hepatitis B, Meningitis |
| Rotavirus-2 | Rotavirus diarrhoea |
At 14 Weeks (3.5 months)
| Vaccine | Disease Prevented |
|---------|-----------------|
| OPV-3 | Polio |
| Pentavalent-3 | Diphtheria, Whooping Cough, Tetanus, Hepatitis B, Meningitis |
| Rotavirus-3 | Rotavirus diarrhoea |
| IPV-2 or fIPV-2 | Polio |
| PCV-2 | Pneumonia, Meningitis |
At 9 Months
| Vaccine | Disease Prevented |
|---------|-----------------|
| MR (Measles-Rubella) — First dose | Measles (a major cause of child death in India), Rubella (German measles) |
| Vitamin A — First dose | Vitamin A deficiency, which severely weakens immunity |
| JE-1 (Japanese Encephalitis Vaccine) | Japanese Encephalitis — in endemic districts (specific states) |
About MR vaccine: Measles spreads through air and is highly contagious. Before the MR vaccine, it killed millions of children globally each year. One dose at 9 months gives about 85% protection; the second dose at 16-24 months raises it to 97%+. Both doses are mandatory.
At 12 Months
| Vaccine | Disease Prevented |
|---------|-----------------|
| PCV-Booster | Pneumonia, Meningitis |
| JE-2 (in endemic districts) | Japanese Encephalitis |
At 16-24 Months (Between 1.5-2 Years)
| Vaccine | Disease Prevented |
|---------|-----------------|
| DPT Booster 1 | Diphtheria, Whooping Cough, Tetanus |
| OPV Booster | Polio |
| MR Second Dose | Measles, Rubella |
| Vitamin A (doses every 6 months until age 5) | Immunity support, eye health |
At 5-6 Years (School Entry)
| Vaccine | Disease Prevented |
|---------|-----------------|
| DPT Booster 2 | Diphtheria, Whooping Cough, Tetanus |
At 10 Years and 16 Years
| Vaccine | Disease Prevented |
|---------|-----------------|
| Td (Tetanus-Diphtheria) | Tetanus, Diphtheria |
What to Expect After Each Vaccine — Normal vs. Warning Signs
Many parents worry when a baby cries after an injection or develops a mild fever the next day. This is normal and expected. Here is what is normal and what needs a doctor:
Normal reactions (no action needed except comfort)
- Crying immediately after injection — the injection hurts. Normal. Hold and comfort the baby.
- Mild fever (under 38.5°C / 101.3°F) for 1-2 days — the immune system is responding. Give paracetamol drops at the dose the doctor or ANM tells you. Keep the baby hydrated.
- Redness, swelling, or hardness at the injection site for 2-3 days — especially with DPT. Apply a cool, clean cloth. It resolves on its own.
- Drowsiness and poor feeding for 24 hours — common, especially after first vaccines. Normal.
- Small painless lump at BCG site that develops into a small blister and then a scar over 2-3 months — this is exactly what is supposed to happen. The scar means BCG worked.
Signs to see a doctor
- Fever above 39°C (102.2°F) or fever lasting more than 2 days
- Continuous crying for more than 3 hours that cannot be comforted
- Seizures or convulsions (any jerking of limbs)
- Severe swelling of the arm or leg beyond the injection site
- Baby becomes very drowsy and cannot be woken
- Any rash or difficulty breathing within 15 minutes of vaccination (very rare — the centre staff monitor for this)
What to Do If Doses Were Missed
Life is unpredictable. Children fall sick on vaccine day, families move, floods disrupt schedules. If your child has missed doses, do not assume vaccination must start again from the beginning. This is the most common misunderstanding, and it prevents thousands of children from catching up.
The rule: Missed doses are always caught up. You never restart the series from scratch. You pick up from where you left off and complete the remaining doses.
How to catch up:
- Go to your nearest PHC, sub-centre, or anganwadi and show the MCP card (or describe what was given)
- The ANM will look at what is missing and make a catch-up schedule
- If the card is lost, start from the earliest age-appropriate vaccine — this slightly over-vaccinates but is completely safe and better than remaining unprotected
There is no age that is "too late" to catch up on most vaccines. Even a 2-year-old can be started on BCG, polio, and measles if they missed them. For older children, the Td booster (10 and 16 years) remains available.
Where to Get Free Vaccines in Your Area
2. Government Health Centres (PHC/CHC/UPHC): Vaccines are available every working day at Primary Health Centres. Urban Primary Health Centres serve cities and towns.
3. Village Health Sanitation and Nutrition Days (VHSNDs): Monthly outreach sessions held at anganwadis where ANMs bring vaccines to the village. Your ASHA will tell you the next VHSND date.
4. Pulse Polio rounds: Special mass OPV campaigns, usually in January-February, where all children under 5 receive polio drops — even if already vaccinated. Participate every time.
5. Call 104 Health Helpline: The national health helpline can direct you to the nearest vaccination site and answer basic questions about the schedule (available in local languages).
Vaccines Available at Private Clinics (Not in UIP)
Some vaccines are recommended by the Indian Academy of Pediatrics (IAP) but are not yet part of the free government schedule. These include:
| Vaccine | Disease | Approximate Cost |
|---------|---------|-----------------|
| Varicella | Chickenpox | ₹700-1,500 per dose |
| Hepatitis A | Hepatitis A liver infection | ₹700-1,500 per dose |
| Typhoid Conjugate Vaccine | Typhoid fever | ₹500-900 |
| MMR (instead of MR) | Measles, Mumps, Rubella | ₹400-700 |
| Influenza (annual) | Seasonal flu | ₹700-1,200 |
| HPV | Cervical cancer | ₹2,000-4,000 per dose |
These are optional additions to the free UIP schedule. Many paediatricians strongly recommend them. HPV vaccine for girls aged 9-14 is particularly important — it prevents the most common cause of cervical cancer, which kills 77,000 Indian women each year. Some state governments are introducing HPV vaccination free of cost in schools — check with your child's school or district health department.
Common Myths — Addressed Directly
"Vaccines are too many at once and weaken immunity."
Wrong. The immune system of a healthy infant can handle thousands of antigens daily. The combination vaccines (like Pentavalent) are specifically designed to be given together — they are tested and approved as a set. Delaying or spacing out vaccines leaves the child unprotected for longer.
"My child had fever after the last vaccine, so I'm afraid of the next one."
Fever after vaccines is a sign the immune system is responding — it is not a sign of harm. The risk of the disease the vaccine prevents is always far greater than the risk of the vaccine's side effects.
"We don't need vaccines because my child is healthy and eats well."
Good nutrition strengthens immunity, but it cannot replace specific antibodies that only vaccination creates. A well-fed, healthy child with no measles vaccine is still fully vulnerable to measles.
"The vaccine caused my child to get the disease."
Most UIP vaccines contain killed or weakened viruses/bacteria that cannot cause the actual disease. The oral polio vaccine (OPV) carries an extremely rare risk of vaccine-derived polio (roughly 1 in 2.7 million doses) — which is why the IPV (injectable, killed virus) is now given alongside it.
Action Steps for This Week
- Find your MCP card and check which vaccines have been given and which are due
- Know your ASHA worker's name and phone number — she is your local point of contact for all immunizations
- Mark vaccination dates on your phone's calendar with reminders set 1 week in advance
- If your child is over 2 and you're not sure what was given, visit the nearest PHC with the MCP card — the ANM will assess and make a catch-up plan
- Tell other parents — every parent you share this information with is a child protected
Your child cannot make this decision. You can.
