A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen. Vaccines go through multiple phases of trials to ensure safety and effectiveness. World Health Organization-guided childhood vaccine schedules protect against 30 infectious diseases, and following them is crucial to prevent risks to children and the community, having saved over 154 million lives in the past 50 years.

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 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.Update on Yellow Fever in the Americas, http://www.paho.org/english/SHA/be_v21n2-yellowfever.htm, the Epidemiological Bulletin, Vol. 21 No. 2, June 2000, Pan American Health Organization, accessed July 18, 2007 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 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 World Health Organization (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 Childhood vaccine schedules, guided by World Health Organization and developed by global experts, protect against 30 infectious diseases. Following the recommended schedule is crucial, as delays or changes increase risk for children and the community.

The World Health Organization 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, anthrax, cholera and smallpox.

+ Diseases covered by the vaccination schedule in each countryCountry

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.

+ Vaccine Schedule for Australia: 1 April 2019 Infection Birth Months Years Women 2 4 6 12 18 4 12–<13 14–<16 >15 >50 65+ 70 Rotavirus RV RV Hepatitis A HepA§ HepA§ Hepatitis B HepB DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib Diphtheria Tdap Tdap Pertussis Tetanus Polio DTaP-HepB-IPV-Hib Haemophilus influenzae Meningococcus MenACWY MenACWY MenACWY MenACWY Pneumococcus PCV13 PCV13 PCV13 PCV13 PCV13 PCV13§ PPSV23 PPSV23§ PPSV23§ PPSV23 Measles MMR MMRV MMRV Mumps Rubella Varicella Human papillomavirus HPV x2 HPV x2 Influenza IIV (yearly) IIV (yearly) IIV (yearly) IIV (yearly)§ Herpes Zoster ZVL

Austria Austrian vaccine recommendations are developed by the National Vaccination Board (), which is part of the Federal Ministry of Social Affairs, Health, Care and Consumer Protection.

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. +Brazilian National Vaccination Schedule: 2019InfectionGestationBirthMonthsYears 2 3 4 5 6 9 12 15 4 5 9 11 10–59 60+ Tuberculosis BCG Leprosy Hepatitis A HepA Hepatitis B HepB 5V 5V 5V Diphtheria DTPa DTP DTP dT Tetanus Pertussis Haemophilus influenzae Polio IPV IPV IPV OPV OPV Pneumococcus 10v 10v 10v Meningococcus MenC MenC MenC MenC Rotavirus RV RV Measles MMR MMRV Mumps Rubella Varicella VV Yellow fever YF Human papillomavirus HPVx2 (girls) HPVx2 (boys) Flu IIV IIV (yearly) IIV (yearly)

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

Alberta

+ Alberta Vaccine Schedule: 2015InfectionMonthsYears 2 4 6 12 18 4 10–13 15–17 65+ Hepatitis B HepB Diphtheria DTaP DTaP DTaP DTaP DTaP Tdap Tetanus Pertussis Haemophilus influenzae HIB HIB HIB HIB Pneumococcus PneuC13 PneuC13 PneuC13 Polio IPV IPV IPV IPV IPV Measles MMRV MMRV Mumps Rubella Varicella Meningococcus MenC MenC MenC-ACYW Human papillomavirus HPV HPV (boys) Flu IIV (yearly)

British Columbia

+ British Columbia Vaccine Schedule: 2015InfectionMonthsYears 2 4 6 12 18 4 10–13 15–17 65+ Hepatitis B HepB HepB HepB Rotavirus RV RV Diphtheria DTaP DTaP DTaP DTaP Tdap Tetanus Pertussis Haemophilus influenzae HIB HIB HIB HIB Pneumococcus PneuC13 PneuC13 PneuC13 Polio IPV IPV IPV IPV IPV Measles MMR MMRV Mumps Rubella Varicella VV Meningococcus MenCCV MenCCV Human papillomavirus HPV (girls) Flu IIV (yearly)

New Brunswick

+ New Brunswick Vaccine Schedule: 2015InfectionBirthMonthsYears 2 4 6 12 18 4 10–13 15–17 65+ Hepatitis B HepB HepB HepB Diphtheria DTaP DTaP DTaP DTaP DTaP Tdap Tetanus Pertussis Haemophilus influenzae HIB HIB HIB HIB Pneumococcus PneuC13 PneuC13 PneuC13 Polio IPV IPV IPV IPV IPV Measles MMRV MMRV Mumps Rubella Varicella Meningococcus MenCCV MenC-ACYW Human papillomavirus HPV (girls) Flu IIV (yearly)

Ontario

+ Ontario Vaccine Schedule: 2017InfectionMonthsYears 2 4 6 12 15 18 4 10–13 15–17 Hepatitis B HepB Rotavirus RV RV Diphtheria DTaP DTaP DTaP DTaP DTaP Tdap Tetanus Pertussis Haemophilus influenzae HIB HIB HIB HIB Pneumococcus PCV13 PCV13 PCV13 Polio IPV IPV IPV IPV IPV Measles MMRV MMRV Mumps Rubella Varicella VV Meningococcus MenC MenC-ACYW Human papillomavirus HPV (girls)

Quebec

+ Quebec Vaccine Schedule: 2019InfectionMonthsYears 2 4 6 12 18 4–6 9 14–16Adult 50 65 75 Hepatitis A HepA Hepatitis B HepB HepB HepB HepB Rotavirus RV RV Diphtheria DTaP DTaP DTaP DTaP Tdap Tdap Tdap Tdap Tetanus Pertussis Haemophilus influenzae HIB HIB HIB HIB Pneumococcus PCV10 PCV10 PCV10 PPV23 Polio IPV IPV IPV IPV IPV Measles MMR MMRV Mumps Rubella Varicella VV Meningococcus MenCC MenCC Human papillomavirus HPV Flu IIV IIV IIV IIV (yearly)

Finland

+ Vaccination Schedule for Finland Infection Birth Months Years 2 3 5 6 12 18 3 4 6 11–12 14–15 25 65+ Tuberculosis BCG Rotavirus RV RV RV Diphtheria DTaP DTaP DTaP DTaP Tdap Td (10yearly) Tetanus Pertussis Polio IPV IPV IPV IPV Haemophilus influenzae HIB HIB HIB Hepatitis B HepB Pneumococcus PCV10 PCV10 PCV10 PCV13 + PPSV23 Measles MMR MMRV Mumps Rubella Varicella VV Human papillomavirus HPV Influenza IIV3 IIV3 Tick-borne encephalitis TBE 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

+ Vaccination Schedule for France Infection Months Years 0 1 2 4 6 11 12 13 15 16–18 23 2 5 6 11–13 25 45 65+ Tuberculosis BCG BCG Diphtheria D D D D D d Tetanus TT TT TT TT TT Pertussis acP acP acP acP acp Polio IPV IPV IPV IPV IPV Haemophilus influenzae Hib Hib Hib Hepatitis B HepB HepB HepB HepB HepB Pneumococcus PCV PCV PCV Meningococcus MenC Measles MEAS MEAS Mumps MUMPS MUMPS Rubella RUMBE RUMBE Human papillomavirus HPV Influenza TIV Herpes Zoster HZ

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 recommendations are generally adopted by the Federal Joint Committee.

+ Vaccination Schedule for Germany Infection Weeks Months Years 6 2 3 4 11 12 14 15 23 2 5–6 9 14 15 17 18–45 59 >60 Rotavirus RV RV RV Diphtheria D D D D D d d d d Tetanus TT TT TT TT TT TT TT TT TT Pertussis acP acP acP acP acP acP acp acp acp Polio IPV IPV IPV IPV IPV IPV IPV IPV Haemophilus influenzae Hib Hib Hib Hib Hib Hib Hepatitis B HepB HepB HepB HepB HepB HepB Pneumococcus PCV PCV PCV PCV PCV Pnc PPSV23 Meningococcus MenC MenC Measles MEAS MEAS MEAS MEAS Mumps MUMPS MUMPS MUMPS Rubella RUMBE RUMBE RUMBE Varicella VAR VAR VAR Human papillomavirus HPV HPV Influenza TIV Tick-borne Encephalitis TBE

Hong Kong

In Hong Kong, Department of Health 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.

+IAP Immunization Timetable: 2016InfectionBirthMonthsYears 1.5 2.5 3.5 6 9 9–12 12 15 16–18 18 2 4–6 10–12 Tuberculosis BCG Polio OPV OPV OPV OPV Hepatitis B HepB HepB HepB Rotavirus RV RV RV Diphtheria DTwP DTwP DTwP DTwP DTwP Tdap Tetanus Pertussis Haemophilus influenzae HIB HIB HIB HIB Pneumococcus PCV PCV PCV PCV Polio IPV IPV IPV IPV Measles MMR MMR MMR Mumps Rubella Typhoid TCV TCV Hepatitis A HepA HepA Varicella VV VV Human papillomavirus HPV (girls)

Italy

+ Vaccination Schedule for Italy Infection Birth Months Years 3 5–6 11 13 15 5–6 11–18 65+ Diphtheria D D D D d Tetanus TT TT TT TT TT Pertussis acP acP acP acP acp Polio IPV IPV IPV IPV Haemophilus influenzae Hib Hib Hib Hepatitis B HepB HepB HepB HepB Pneumococcus PCV PCV PCV Meningococcus MenC MenC Measles MEAS MEAS MEAS Mumps MUMPS MUMPS MUMPS Rubella RUMBE RUMBE RUMBE Varicella VAR Human papillomavirus HPV Influenza TIV

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.