ASHA ShikshaGuide
Child immunization schedule in India, explained for ASHAs
Which vaccines a child needs from birth to 16 years, what to tell parents about side effects, and how ASHAs make sure no child is missed.
Vaccines protect children from tuberculosis, polio, diphtheria, whooping cough, tetanus, hepatitis B, pneumonia, diarrhoea due to rotavirus, measles, rubella and, in some districts, Japanese encephalitis. All these vaccines are free under the Universal Immunization Programme. Your job is to make sure every child in your area gets every dose on time.
The schedule
- At birth: BCG, OPV zero dose and hepatitis B birth dose (within 24 hours).
- 6 weeks: OPV-1, Pentavalent-1, Rotavirus-1, fIPV-1, PCV-1.
- 10 weeks: OPV-2, Pentavalent-2, Rotavirus-2.
- 14 weeks: OPV-3, Pentavalent-3, Rotavirus-3, fIPV-2, PCV-2.
- 9 to 12 months: MR-1 (measles-rubella), fIPV-3, PCV booster, JE-1 in JE districts, and the first dose of vitamin A.
- 16 to 24 months: MR-2, JE-2, DPT booster-1, OPV booster and vitamin A (2nd dose). Then vitamin A every 6 months until 5 years.
- 5 to 6 years: DPT booster-2.
- 10 years and 16 years: Td.
A child who has received BCG, three doses of OPV and Pentavalent, and MR-1 before the first birthday is called fully immunized.
Pregnant women
Every pregnant woman needs Td: two doses one month apart, or one booster dose if she received two doses in a pregnancy within the last three years. This protects both mother and baby from tetanus.
What to tell parents about side effects
- Mild fever, crying, pain or swelling where the injection was given are common and go away in one or two days.
- After BCG, a small blister forms after a few weeks and heals into a small scar. This is normal; do not apply anything on it.
- Several vaccines on the same day are safe and do not overload the child.
- A child with a mild cold, cough or loose stools can still be vaccinated.
Report any serious reaction, such as high fever, fits, difficulty in breathing, or a child who is very unwell after vaccination, to the ANM or Medical Officer at once.
Your role before, during and after the session
- Make a due list of all pregnant women and children in your area who need a vaccine at the next session.
- Visit or call the families a day before and remind them of the date, place and time.
- On the session day (VHSND), bring the children and help the ANM.
- Write the next due date on the MCP card and tell the mother.
- Follow up children who did not come and bring them to the next session.
Find the children who are missed
Pay special attention to zero-dose children who have never received any vaccine, children of migrant families, children in brick kilns and construction sites, and families who refused earlier. Listen to their worries, answer gently, and involve the ANM, anganwadi worker or a respected local person if needed.
If a child has missed a dose, it is never too late. The missed doses can be given at the next session according to the child's age. Never tell a family that the child is too old to start.
Common questions
The child had fever after the last vaccine. Should we skip the next one?
No. Mild fever after a vaccine is common. Give the next dose on time; the ANM can advise paracetamol if needed.
Does the child need the vaccine if it had measles before?
Yes. Give MR as per the schedule; it also protects against rubella.
Can OPV be given if the child has diarrhoea?
Yes. Give the dose and record it. The ANM will decide if an extra dose is needed.
Sources: MoHFW Universal Immunization Programme schedule; Immunization Handbook for Health Workers; NHM ASHA training modules.