Japan Childhood Vaccination Schedule 2026: A Parent’s Guide

Disclaimer: This article is for general informational purposes only and is not medical advice. Always confirm which vaccines your child needs, and when, with a pediatrician and your local city or ward office. The information reflects the system as of October 2026.

Introduction: Japan’s Vaccinations Feel Familiar, but Work a Little Differently

You open a thick envelope from the city office and find a stack of pre-vaccination questionnaires (yoshinhyo, the health check forms you fill out before each shot). There are lots of them, and it’s not clear which one to use when. Many of us raising kids in Japan for the first time have been in exactly that spot.

A vaccine that was one shot back home may be split into two in Japan. On the other hand, Japan protects against five diseases with a single shot. Some vaccines that other countries skip, like BCG, are part of Japan’s routine schedule. If you head to a clinic without knowing these differences, you may hear “we can’t give that today” and have to come back.

Based on the system as of October 2026, this guide covers:

• Japan’s vaccination schedule from birth to high school, with quick-reference tables
• What changed between 2024 and 2026, and what is about to change
• The steps from arriving in Japan to your child’s first shot
• How to connect vaccines received abroad to Japan’s schedule
• Where to get help in English and other languages, including multilingual questionnaires

Vaccinations are one of the most hands-on ways Japan helps protect children. Let’s go through it step by step.

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1. Routine vs. Voluntary Vaccinations: This Decides Whether It’s Free

Vaccinations in Japan fall into two groups: routine vaccinations (teiki sesshu) and voluntary vaccinations (nin’i sesshu). If you don’t know the difference, you might expect a free shot and end up paying several thousand yen, or even more than ¥10,000, at the reception desk.

(Reference: MHLW "Vaccination and Vaccine Information" (Japanese))

Free routine vaccinations for children

As of October 2026, children can receive these routine vaccinations for free:

• From age 0: Hepatitis B, rotavirus, the 5-in-1 vaccine (diphtheria, pertussis, tetanus, polio, and Hib), pediatric pneumococcal, and BCG (tuberculosis)
• From age 1: MR (measles and rubella) and varicella (chickenpox)
• From around age 3: Japanese encephalitis
• From the upper elementary years: DT (diphtheria and tetanus) and HPV (human papillomavirus, for girls from 6th grade through the first year of high school, or the equivalent age)

Since April 2026, the RSV maternal vaccine for pregnant women has also become a routine vaccination. Antibodies made in the mother’s body pass to the baby and help prevent severe illness after birth (more on this in Section 4).

Main voluntary (paid) vaccinations

• Mumps: The Japan Pediatric Society recommends two doses. It is expected to become a routine vaccination in fiscal 2027 (see Section 4)
• Influenza: The injected vaccine is available from 6 months old, and children under 13 usually get two doses each year. From age 2 to 18, a nasal spray vaccine (one dose a year) is also an option
• Hepatitis A and meningococcal: Sometimes recommended before travel abroad or before living in a dormitory

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2. Vaccination Schedule for Age 0: Two Months Is “Vaccine Debut”

In Japan, vaccinations begin in earnest at 2 months of age. Babies get many vaccines in their first year, so expect to visit the clinic almost every month for the first few months.

Quick reference: Standard schedule for age 0

(Reference: Know VPD! "Let’s Plan a Vaccination Schedule" (Japanese) / MHLW "Vaccination and Vaccine Information" (Japanese))

This table shows the standard order. It’s very common for a cold to push things back by a month, so if you fall behind, ask your pediatrician to rearrange the schedule.

Notes on each vaccine

The 5-in-1 vaccine combines the former 4-in-1 vaccine and Hib into a single shot. It became a routine vaccination in April 2024. Your child gets three doses starting at 2 months, at least 20 days apart, then a fourth dose at least 6 months after the third (usually 6 to 18 months later).

For pediatric pneumococcal, the 20-valent vaccine (PCV20, which protects against 20 strains) has been used for routine vaccination since October 2024. The standard is three doses from 2 months, then a fourth dose between 12 and 15 months of age.

Hepatitis B requires three doses before the first birthday. The third dose must be at least 139 days after the first, so it usually falls around 7 to 8 months.

BCG protects against tuberculosis. It is free until the first birthday. It’s given with a stamp-like device pressed onto the arm. A few weeks later, the needle marks may turn red or look like small pus spots. This is a normal reaction, so leave it alone and keep an eye on it. Some municipalities give BCG as a group vaccination at the public health center.

Rotavirus has the strictest deadline

The rotavirus vaccine is given by mouth, not by injection. It has been a routine vaccination since October 2020. The thing to watch most closely is the deadline.

For both types, the first dose is recommended by 14 weeks 6 days of age. Starting the first dose after that is not recommended. If you arrive in Japan just before your baby turns 2 months, book rotavirus first for peace of mind.

(Reference: Tokyo Metropolitan Bureau of Public Health "Rotavirus Infection" (Japanese))

“Four shots at once? Is that okay?”

Many parents are surprised to hear their baby will get four vaccines on the same day at 2 months. Simultaneous vaccination (giving several vaccines on the same day) is common practice both in Japan and around the world. The Japan Pediatric Society also states that giving vaccines together does not increase side effects.

The biggest benefit is that your child builds the immunity they need early. It also means fewer clinic visits, which really helps when you’re raising kids in a new country. If you’re worried, tell the doctor you’d like to talk about simultaneous vaccination. They can explain the options, including spreading the shots over different days.

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3. Vaccination Schedule from Age 1 to High School

Things calm down after the first year, but there’s another busy stretch around the first birthday.

Quick reference: Routine vaccinations from age 1

(Reference: MHLW "Vaccination and Vaccine Information" (Japanese))

Around the first birthday, many families get MR, varicella, the 4th pneumococcal dose, and mumps (voluntary) at the same time. Booking right after the birthday helps you avoid missing any.

MR Phase 2 is free only during the final year of kindergarten or nursery school. If your child doesn’t get it between April and the following March, you’ll have to pay after that. Because of a vaccine shortage in fiscal 2024, children who couldn’t get MR that year (Phase 1: born April 2, 2022 to April 1, 2023; Phase 2: born April 2, 2018 to April 1, 2019) can still get it for free until March 31, 2027.

For the HPV vaccine, starting the 9-valent vaccine (Silgard 9) before age 15 means only two doses are needed (at least 5 months apart). Starting at 15 or older requires three doses.

(Reference: MHLW "About the 9-valent HPV Vaccine (Silgard 9)" (Japanese))

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4. Changes from 2024 to 2027: Watch Out for Outdated Information

Japan’s vaccination system has changed a lot over the past few years. What you hear from friends back home, read in older online posts, or learn from someone who raised kids in Japan a few years ago may no longer be accurate.

RSV vaccine for pregnant women (free since April 2026)

RSV (respiratory syncytial virus) can easily lead to pneumonia or bronchiolitis (inflammation of the small airways) in babies. Infants under 6 months are thought to be especially at risk of severe illness.

Since April 2026, pregnant women between 28 weeks 0 days and 36 weeks 6 days can get one dose of the maternal vaccine for free. If you’re pregnant or planning to give birth in Japan, ask your OB-GYN about it at a prenatal checkup. We’ve covered the whole process of having a baby here in our complete guide to giving birth in Japan.

(Reference: MHLW "RSV Vaccine" (Japanese))

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The MMR vaccine and mumps becoming routine

“Japan doesn’t have MMR” has long confused parents who grew up elsewhere. Japan introduced an MMR vaccine in 1989 but stopped it in 1993 because of side effect concerns. Since then, only MR (measles and rubella) has been routine, while mumps has been a separate, voluntary shot.

That is starting to change:

• May 2026: The Ministry of Health, Labour and Welfare (MHLW) approved an MMR vaccine developed by Daiichi Sankyo
• July 2026: An MHLW expert subcommittee supported making the mumps vaccine routine. The plan is two doses: one at age 1 and one before starting elementary school

If the higher-level council also approves and it is formally decided, mumps is expected to become a free routine vaccination as early as fiscal 2027. As of October 2026, though, mumps is still voluntary and paid. If your child is around 1 year old now, talk to your pediatrician about whether to get it now rather than wait.

(Reference: Kumamoto Nichinichi Shimbun "Combined MMR Vaccine Approved, First in About 30 Years" (Japanese) / Kumamoto Nichinichi Shimbun "MHLW Expert Subcommittee Supports Routine Mumps Vaccination" (Japanese))

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5. What to Do First After Arriving: From Resident Registration to the First Shot

Free vaccinations in Japan assume that you are registered as a resident of the municipality where you live. Questionnaires are issued based on your resident registration, so if you register late, the questionnaires come late too.

Here is the order to follow from arrival to the first shot.

Step 1: File your Moving-in Notification at the city or ward office

Once you have a place to live, file a Moving-in Notification (Tennyu Todoke) at your City Hall or Ward Office (ku-yakusho) within 14 days. Register your children at the same time. We explain how the resident record works and how to get a copy in our guide to getting your Juminhyo.

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Step 2: Get the questionnaires at the public health center

For babies born in Japan, questionnaires are usually mailed after the birth is registered. Children who move here from abroad, however, may not receive them automatically. After filing your Moving-in Notification, go to the children’s services counter or the public health center the same day and ask for vaccination questionnaires (yobo sesshu no yoshinhyo).

Bringing these will speed things up:

• Mother and Child Health Handbook (Boshi Techo), if your child was born in Japan or you’ve lived here before
• Records of vaccinations received abroad (ideally in English)
• Your child’s passport or Residence Card (Zairyu Card)

Step 3: Get a Mother and Child Health Handbook

The Mother and Child Health Handbook (Boshi Techo) is a booklet unique to Japan that records everything from pregnancy to your child’s growth and vaccinations. You need to bring it for every routine vaccination. Even if your child was born abroad, many municipalities will issue one at the counter, so ask.

There are also bilingual versions, printed alongside Japanese, in 10 languages: English, Chinese, Korean, Spanish, Portuguese, Vietnamese, Indonesian, Thai, Tagalog, and Nepali. Some municipalities hand out these versions when you register a pregnancy, so it’s worth asking.

(Reference: Kawasaki City "How Do I Get a Mother and Child Health Handbook?" (Japanese))

Step 4: Book a pediatric clinic

Once you have the questionnaires, book an appointment at a medical institution designated by your municipality (most pediatric clinics are). When you book, tell them which vaccine you want and which dose number it is. Many Japanese clinics work by appointment and order vaccines to match bookings, so if you just show up, they may not have it in stock.

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6. Transferring Vaccine Records from Abroad and Catching Up

“We already did about half the vaccines back home. What do we do in Japan?” This is one of the most common questions we hear from international families. Vaccines received abroad still count in Japan, so think of it as filling in the gaps using Japan’s schedule. This is called a “catch-up.”

Three steps to transfer your records

Step 1: Prepare your vaccination record from abroad

Get the official immunization record issued by your doctor back home. Ideally it should show the vaccine names, dates, and lot numbers. Most pediatricians in Japan can read an English record. If it’s in another language, adding an English translation makes things smoother.

Step 2: Ask a pediatrician to copy it into the Boshi Techo

Have a Japanese pediatrician transfer your child’s vaccination history into the Mother and Child Health Handbook. That way, any doctor or public health center in Japan can see at a glance which vaccine and dose comes next.

Step 3: Identify what’s missing together

If your child is still within the eligible age for Japan’s routine vaccinations, the missing doses are free. Since vaccine combinations, dose counts, and intervals differ between countries, decide which vaccines to get, and how many doses, with your doctor.

(Reference: Know VPD! "Let’s Plan a Vaccination Schedule" (Japanese))

Quick decision table: Your vaccine history abroad and how Japan treats it

This is a rough guide to how vaccines received in your home country are treated in Japan. The final decision is made by your pediatrician and municipality.

What to check before starting at an international school

Most international schools ask for an English vaccination record at enrollment. For children who have only had Japan’s routine vaccines, the most common gap is mumps. Since Japan’s routine vaccine is MR, the mumps field is often blank.

If you’re considering an international school, check these two things early:

• Mumps: Whether the school requires two documented doses. Since it’s voluntary, get it at your own cost ahead of time
• English vaccination certificate: Whether your pediatrician can issue one. There’s often a fee, and it may take a few days

For the differences between international and public schools, see our comparison of international schools and public schools.

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7. Finding a Pediatrician and Preparing for Vaccination Day

Pediatricians in Japan tend to be very thorough, but how much English is spoken varies from clinic to clinic. Knowing the support available ahead of time helps take the edge off the language barrier.

Use the multilingual questionnaires

The Vaccination Research Center (a public interest foundation that produces vaccination materials) publishes translated versions of the pre-vaccination questionnaire for free. They’re available in English, Chinese, Korean, Vietnamese, Spanish, Portuguese, Thai, Indonesian, Tagalog, Nepali, and more, printed side by side with Japanese.

Once you understand the questions in your own language, filling out the Japanese questionnaire from your municipality makes the medical interview much easier. The same page has translated editions of the booklet “Vaccinations and Children’s Health” (Yobo Sesshu to Kodomo no Kenko), which is great if you want to read the basics in your native language.

(Reference: Vaccination Research Center multilingual materials page)

Phone lines for help in English

If you want to find a clinic where you can be seen in your language, or have questions about Japan’s healthcare system, these lines can help.

The days each language is available can change, so check the official website before calling.

(Reference: AMDA International Medical Information Center / Chuo City "Medical Consultation" (Japanese))

Vaccination day checklist

Old-style health insurance cards expired on December 1, 2025, and the temporary measure that let people keep using expired cards ended at the end of July 2026. You now need the My Number health insurance card or an eligibility certificate. Check with the clinic which ones to bring along with your child’s medical subsidy card. For details on the switch, read our article on the old insurance card deadline and switching to the My Number insurance card.

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(Reference: Chiba City "What to Bring for Baby and Child Vaccinations" (Japanese))

Side effects and aftercare

After a shot, you’ll be asked to wait about 30 minutes in or near the clinic. This is so staff can respond right away to a rare but serious allergic reaction (anaphylaxis).

Common side effects include:

• Fever: Your child may develop a fever on the day of or the day after the shot. If they’re in a good mood and drinking milk or fluids, it’s usually fine to watch and wait
• Swelling and redness: The injection site may turn red and swell. This normally settles within a few days
• After BCG: A few weeks later, the needle marks may look like small pus spots. This is a normal reaction

If a high fever continues, your child seems limp or unresponsive, or has a seizure, see a doctor right away. For help deciding what to do at night or on holidays, see our guide for when your child suddenly gets sick in Japan.

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The relief system, just in case

If the national government recognizes that a routine vaccination caused health damage, the Relief System for Injury to Health with Vaccination provides benefits such as medical costs and disability pensions. Applications go through the municipality where you were registered when the vaccine was given. The system applies regardless of nationality.

(Reference: MHLW "Relief System for Injury to Health with Vaccination" (Japanese))

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FAQ

Q: What happens if my child passes the eligible age for a routine vaccination?

A: Even one day past the eligible age, the vaccine is treated as voluntary and you pay the cost. Prices vary by clinic, so check before booking. There is a special exception: if a serious illness requiring long-term treatment prevented vaccination during the eligible period, your child can still receive it as a routine vaccination within two years after treatment ends. Some vaccines have an upper age limit, though, such as before the 4th birthday for BCG and before the 6th birthday for the pneumococcal vaccine.

Q: If a vaccine is due while we’re visiting our home country, can we get it there?

A: You can, but you’ll pay for it yourself, and in most cases your Japanese municipality won’t reimburse you. If the vaccine combination is different, it may also change how the remaining doses are counted in Japan. Talk to your pediatrician in Japan before you go, and if your child is vaccinated abroad, be sure to get a record.

Q: Can my child get the MMR vaccine in Japan?

A: An MMR vaccine was approved in Japan in May 2026, but as of October 2026, the vaccine used for routine vaccination is MR. For now, most families combine MR (routine, free) with the mumps vaccine (voluntary, paid). Mumps is expected to become routine in fiscal 2027, so check with your pediatrician for the latest information.

Q: Can my child be vaccinated at a clinic where no English is spoken?

A: Yes. If you read the translated questionnaire from the Vaccination Research Center, then fill out the Japanese questionnaire and bring it, you can often get through the visit with minimal conversation. If calling to book feels daunting, you can also ask the AMDA International Medical Information Center to suggest clinics that support your language.

Q: Should my child get BCG?

A: In Japan, BCG is a routine vaccination and is free until the first birthday. Some countries, like the US, don’t routinely give it to children, but Japan includes it to prevent severe tuberculosis in infants. If it differs from what you’re used to and you’re unsure, talk it over with your pediatrician.

Q: How many vaccines can be given at once?

A: In Japan, there is no set upper limit if the doctor judges it necessary. Getting four vaccines at once at 2 months is common. If you’re worried, you can discuss spreading them out with your doctor.

Q: Can I breastfeed or bottle-feed before the rotavirus vaccine?

A: Babies tend to spit up right after feeding, so finishing a feed about 30 minutes before the vaccine is a good idea. Even if your baby spits up after the dose, it’s generally not repeated. If you’re concerned, tell the doctor on the spot.

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Key Takeaways

• ✅ Register as a resident and request questionnaires first. Children who move from abroad may not receive questionnaires automatically
• ✅ Rotavirus and BCG have early deadlines. The first rotavirus dose by 14 weeks 6 days, and BCG before the first birthday
• ✅ The system has changed a lot since 2024. The 5-in-1, PCV20, the RSV maternal vaccine, and MMR approval mean older information may be out of date
• ✅ Have your records from abroad copied into the Boshi Techo. Missing doses are free in Japan within the eligible age
• ✅ If language is a worry, use the translated questionnaires and AMDA. If you’re considering an international school, check mumps and an English certificate early

Your first vaccinations in Japan may feel overwhelming with all the new words and paperwork. But once you understand the flow, it’s mostly a routine of bringing the Boshi Techo and questionnaire to the clinic. Why not start by writing the next vaccination date on your calendar?