Changes in the Immunization Schedule Recommended by the Japan Pediatric Society
October 1, 2020
1) Rotavirus vaccines have been included in the routine vaccines.
2) The indication for pneumococcal conjugate vaccine has been expanded.
*We have revised “the Immunization Catch-up Schedule Recommended by Japan Pediatric Society” and“Immunization of Voluntary Vaccines for Children (less than 15 years old).”Vaccination Schedule Recommended by the Japan Pediatric Society October 1, 2020 Japan Pediatric Society
InfantVaccine

TypeBirthHaemophilus influenzae type b

Pneumococcal（PCV13）（Footnote 2）
Hepatitis B
virus
(HBV)

Early Childhood

6w 2m 3m 4m 5m 6m 7m 8m 9-11m

Inactivated①②③

Inactivated①②③①②

Universal

12-15m 16-17m 18-23m

School Age2y 3y 4y 5y 6y 7y 8y 9y≥10y④（Footnote 1）④（Footnote 2）③（Footnote 3）

InactivatedMother-to-child①

Transmission

MonoRotavirus

valentPenta-valent
Diphtheria, Pertussis,
Tetanus, Polio (DPT-IPV）
Diphtheria, Pertussis,
Tetanus（DPT）②③①②①②③（Footnote 5）

Inactivated①②③④（Footnote 6）

Inactivated①②③④（Footnote 6）

Live（Footnote 4）（up to 7.5yrs）（up to 7.5yrs）⑤⑥11-12yrs（Footnote 8）（Footnote7）

Diphtheria, Tetanus（DT）

11yrs

Inactivated①12yrs（up to 7.5yrs）
Inactivated polio virus （IPV） Inactivated①②③④（Footnote 6）⑤（Footnote 9）

BCG

Live

Measles, Rubella（MR）

Live①②①（Footnote 10）

Varicella
Mumps

Live
Live

①②（Footnote 11）②①（Footnote12）

Japanese Encephalitis

InactivatedInfluenza

Inactivated

Human Papilloma Virus（HPV）①②③（up to 7.5yrs）④9-12yrs

Annually（October, November, etc.）①②① ≥13yrs
Junior High Gr.1

Inactivated(Footnote 13）

Gr.6①②③(footnote 14)

Junior High Grade 2 –High School Year 1

Vaccination Schedule Recommended by the Japan Pediatric Society

October 1, 2020

Standard Period, Perspective of the Japan Pediatric Society, Precautions

VaccineType

Haemophilus
influenzae
type bStandard Age of Vaccination and Period

Perspective of the Japan Pediatrics Society

27-56 days (4-8 wks) interval between(Footnote 1) ④: can obtain satisfactory immunity if①-②-③

administered from 12 mos of age.

7-13 mos interval between ③-④

Precautions
・As a routine immunization, ≥27 days interval between①-②-③, ≥7 mos interval between ③-④
・If first dose administered between 7 mos and 11 mos:After ①-② an interval of ≥7 mos then ③Inactivated・If the first dose administered between 1 yr and 4 yrs:
only ①(Hib)・Vaccination possible for children ≥5 yrs if they have riskfactors.
≥27 days (4 wks) interval between

・If first dose administered between 7 mos-11 mos:①-②-③

Pneumococal,Conjugate（PCV13）After ①, ② vaccination, an interval of ≥60 days and≥60 days (2 mos) interval between

after 1 yr of age, followed by catch-up vaccination ③③-④ and administered when the child isInactivated・If first dose administered between 1 yr-23 mos:

1 yr - 1 yr 3 mos①, ② with ≥60 days interval.
・(Footnote 2）Refer to the "Immunization of Voluntary Vaccines
for Children" for voluntary vaccine schedule (in Japanese).
http://www.jpeds.or.jp/modules/activity/index.php?content_id=316① 2 mos

In case of existence of family members with HBV careers otherHepatitis B Virus② 3 mos

than mother, early immunization is warranted, not waiting till 2・（Footnote 3）Immunization schedule for children who
do not receive vaccines during infancy is depending upon（HBV）③ 7-8 mosmos of age.

the one with universal vaccination.

Universal Vaccine①-② Interval of ≥27 days（4 wks）①-③ Interval of ≥139 days (20 wks)

Hepatitis B Virus

Inactivated ① At birth・If mother is positive for HBs antigen, the child will receive（HBV）② 1 movaccine and HB immunoglobulin simultaneously at birth.

Vaccines for③ 6 mos・Vaccine fee is covered by the national health insurance.

Prevention ofMother to Child
Transmission

・See in details at “New strategies for the prevention of mother tochild transmission of HBV" (in Japanese).
http://www.jpeds.or.jp/modules/activity/index.php?content_id=141

Vaccination Schedule Recommended by the Japan Pediatric Society

October 1, 2020

Standard Period, Perspective of the Japan Pediatric Society, Precautions

VaccineTypeStandard Age of Vaccination and Period

As a general rule, we do not recommend the first dose ofbirth.

vaccination after 15 wk of age because of the increase in risk of①: recommended between 8 wks andintussusception within 7 d of vaccination.

under 15 wks RV1 vaccine (Rotarix®):
For①-② a total of 2 doses with aninterval of ≥4 wks.
For RV5 vaccine (RotaTeq®):①-②-③: a total of 3 doses with ≥4 wks

Rotavirus

Live

Perspective of the Japan Pediatrics Society

Vaccination possible from 6 wks afterbetween doses

Precautions
・(footnote 4) Total 2 doses, ② to be completed within
24th wk of age.
・(footnote 5) Total 3 doses, ③ to be completed withinnd32

wk of age.

・Provide first priority to complete the same vaccine, order thesame vaccine if not available, because interchangeability of RV1and RV5 has not confirmed yet.
・Re-vaccineation after vomiting the vaccine is not approved.
Please refer "Q&A for Rotavirus Vaccine" in details at the Ministry of
Health, Labour, and Welfare in details (in Japanese) .
https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/kenkou/index_00001.html
・Outside of Japan, it is not recommended to provide rotavirus
vaccines in children whose mother received treatment withbiological products during pregnancy.
https://assets.publishing.service.gov.uk/government/uploads/system/upl
oads/attachment_data/file/770826/Rotavirus_vaccination_programme__i

Interval of 20-56 days between

Diphtheria,Pertussis, Tetanus,
Polio（DPT-IPV,IPV）①-②-③(Footnote 6) ≥6 mos between ③-④
Inactivated Generally, during 12-18 mos after ③

nformation_document_Nov_2018.pdf
・Interval of ≥20 days between ①-②-③ as a routine
vaccination.
・Currently, it is not approved to use DPT-IPV instead of DPT and IPV
before entering elementary school.
・Use DPT or IPV for the boosters after 5th dose becuase the use ofDPT-IPV is limited 4 times.

https://www.mhlw.go.jp/bunya/kenkou/polio/dl/leaflet_120601.pdf

Vaccination Schedule Recommended by the Japan Pediatric Society

October 1, 2020

Standard Period, Perspective of the Japan Pediatric Society, Precautions

VaccineType

Perspective of the Japan Pediatrics SocietyStandard Age of Vaccination and Period

Precautions

Interval of 20-56 days between①-②-③

Diphtheria,(Footnote 6）≥6 mos between ③-④

Pertussis, Tetanus

Generally, during 12-18 mos after ③（DPT）⑤ ≥5 yrs, <7 yrs, ≥6 mo between（Footnote 7）We recommend a booster vaccine before④-⑤

entering elementary school because low levels of antibody

Inactivated ⑥ 11-12 yrs

・Use 0.5mL（0.1mL for DT vaccine).

against pertussis in children before entering elementary school

Diphtheria,

have been reported. The status of pertussis antibody in children

Pertussis, Tetanus

in 2018 demonstrated that a rate of anti-PT antibody ≥（DPT）

10EU/mL was less than 30% in 9 years old children (inJapanese).

(For the preventionpertussis after enteringhttps://www.niid.go.jp/niid/ja/y-graphs/8788-pertussis-elementary school)

yosokuserum2018.html（Footnote 8）It is possible to use DTaP vaccine instead of DT
vaccine to prevent pertussis.

Diphtheria,Tetanus（DT）

Inactivatedpoliovirus（IPV）

Inactivated①: At 11 yrs until reaching 12 yrs

・According to the Immunization Law, ≥11 yrs, <13 yrs.

Interval of 20-56 days between

・Please refer to vaccination schedule at the JPS①-②-③(in Japanese) for persons who did not complete(footnote 7) ≥6 mos between ③-④

vaccination but was administered OPV vaccine and/or IPV

Generally, during 12-18 mos after ③prior to August 31, 2012.
https://www.mhlw.go.jp/bunya/kenkou/polio/dl/leaflet_120601.pdf

Inactivatedpoliovaccine（IPV）(For the prevention polio
after entering elementaryschool)

Inactivated ⑤ ≥5 yrs, <7 yrs（Footnote 9）We recommend inactivated polio vaccine
before lowering antibodies against polio when children
enter elementary school.

Vaccination Schedule Recommended by the Japan Pediatric Society

October 1, 2020

Standard Period, Perspective of the Japan Pediatric Society, Precautions

Vaccine

TypeBCGLivePerspective of the Japan Pediatrics SocietyStandard Age of Vaccination and Period

Administered under 12 mos of age,generally administered during the period tuberculosis is high.
from 5 mos to <8 mos①: 1 yr - <2 yrs

Measles, Rubella
（MR）

Live

Precautions

Early vaccination required in areas where incidence of・Vaccination possible ≥6mos for post-exposure②: ≥5 yrs - <7 yrs

prophylaxis; however, the vaccine is not counted,(footnote 10) 1 year before entering

regular ① and ② need to be vaccinated.

elementary school

VaricellaLive①: 12-15 mos（Footnote 11）It is necessary to provide 2 doses of varicella②: 6-12 mos aftervaccine for children who are not suffered from varicella andunvaccinated.

①: ≥1 yr・①-②: Leave an interval of ≥3 months as a routine
vaccination.
・①-②: Leave an interval of ≥4 weeks if ≥13 yrs.

(Footnote 12) To ensure vaccine efficacy, 2 doses arenecessary.

Mumps①: early vaccination at 1 yr of age

Live②: simultaneous administration with 2nd dose of MR(≥5 yrs - <7 yrs, 1 year before entering elementary school isrecommended).

JapaneseEncephalitis

Inactivated①, ②: 3 yrs, leave a 6-28 days interval

We recommend vaccination for Japanese encephalitis (JE)

between ①-②

vaccine from 6 months of age in children who will travel or stay ・For general routine vaccinations, first set administered③: 4 yrs

in the endemic area of JE, or live in the area where high titers④: 9 yrsof JE in pigs is confirmed. “Recommendation for JE vaccine from・A dose per vaccination: 6mos- <3 yrs: 0.25mL; ≥3 yrs: 0.5mL
from 6 mos to under 90 mos (7.5 yrs), and second set atage 9 to under 13 yrs.

6 months of age in children with high risks

・Interval of ≥6 days between ①-②, ≥6 mos between ② and ③.

for JE (in Japanese)" .

・For children who were born from April 2, 2007 to October 1,

http://www.jpeds.or.jp/modules/activity/index.php?content_id=207

2009, it is possible to receive vaccine as a routine vaccine
if they did not receive 1st stage (①, ②, ③） during
6 mos-<90 mos (7 yr 6mos) or 9 yrs to <13 yrs.
・Due to the assertive recommendation to refrain fromadministration in May 2005, a detailed schedule for those
who were born between April 2, 1995 and October 1,2009 (in Japanese) .

http://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou20/annai.html

Vaccination Schedule Recommended by the Japan Pediatric Society

October 1, 2020

Standard Period, Perspective of the Japan Pediatric Society, Precautions

VaccineInfluenza

Type
InactivatedStandard Age of Vaccination and Period

Perspective of the Japan Pediatrics Society

Leave an interval of 4 wks between ①
and② (2-4 wks)
Junior high school Grade 1Precautions
・<13 yrs: 2 doses, ≥13 yrs: 1 or 2 doses.
・Single dose: 6 mos - <3 yrs: 0.25 mL; ≥3 yrs: 0.5 mL.

Although active recommendation for HPV vaccine has been

HPV2 vaccine (Cervarix®): 1 mo interval suspended since June, 2013, we recommend active

・Vaccine given as intramuscular injection (upper arm,deltoid area) .

between ①-②, leave 6 mos between ①- immunization because we have strategies for the understanding ・By the Immunization Law, 12-16 yrs (elementary school

Human PapillomaVirus（HPV）

Inactivated③and analyses of adverse events of HPV vaccine, establishment

HPV4 vaccine (Gardasil®): 2 mosof reporting system and management/counseling for symptoms ・(Footnote 13) HPV2 vaccine can be administered frominterval between ①-②, leave 6 mosafter vaccination, and rescue for recipients who received healthbetween ①-③

issues (by the Professional Promotion Counsil of Immunization,(in Japanese) .

grade 6 to high school year 1) female.
≥10 yrs, HPV4 vaccine ≥9 yrs.
・(Footnote 14) Vaccination possible as routine vaccinationwith the interval below if not administered in regularschedule (Note the difference in the interval required for

http://vaccine-kyogikai.umin.jp/pdf/20160418_HPV-vaccine-routine vaccination between the 2 vaccines). HPV2

opinion.pdf

vaccine: ≥1 mo between ①-②; ≥5 mos between ①-③
and ≥2.5 mos between ②-③; HPV4 vaccine: ≥1 mobetween ①-②, and ≥3 mos between ②-③.

Immunization Check List
Name：
Vaccines

TypeDate of Birth：

Dose 1

Dose 2//

Dose 3

Routine vaccine

Dose 4

Voluntary vaccine

Dose 5Dose 6

Haemophilus
influenzae type b

Inactivated □（//） □（//） □（//） □（//）□（//） □（//） □（//） □（//） □(Hib)
Pneumococcal
conjugate (PCV13)

Inactivated（//）

Refer to Footnote 2

Hepatitis B (HBV)

Rotavirus

Inactivated □（//） □（//） □（//）□（//） □（//） □（//）

Live

Dose 2 final for RV1 (Rotarix)

Dose 3 final for RV5 (RotaTeq)

Diphtheria, Pertussis,Tetanus, Poliovirus

Inactivated □（//） □（//） □（//） □（//）(DPT-IPV)
Diphtheria, Pertussis,Inactivated□（//） □

Diphtheria, Tetanus (DT)Inactivated□（//）

Polio （for polio）

Inactivated□（//）

Tetanus (DPT) (for（//pertussis)

BCGLive□（//）

Measles, Rubella (MR)Live□（//） □（//）

VaricellaLive□（//） □（//）

MumpsLive□（//） □（//）

Inactivated □（//） □（//） □Japanese
encephalitis
Influenza
Human papillomavirus(HPV)（//） □//）（//）

Inactivated （Annual vaccination recommended, refer to the 2nd sheet）
Inactivated □（//） □（//） □（October 1, 2020, Japan Pediatric Society）

Influenza Vaccination Checklist
Name：
Age

Date of Birth：

Dose 1

Dose 2/年齢/Dose 1

Dose 2

6-11 mos

□

（//）

□（//）

8 yrs

□

（//）

□（//）

1 yr

□

（//）

□（//）

9 yrs

□（//）

□（//）

2 yrs

□（//）

□（//）

10 yrs

□（//）

□（//）

3 yrs

□

（//）

□（//）

11 yrs

□（//）

□（//）

4 yrs

□（//）

□（//）

12 yrs

□（//）

□（//）

5 yrs

□

（//）

□（//）

13 yrs

□

（//）

6 yrs

□

（//）

□（//）

14 yrs

□

（//）

7 yrs

□

（//）

□（//）

15 yrs□（//）

October 1, 2020, Japan Pediatrics Society