Paediatric Immunisation Scheduler
The NIS and IAP schedules side by side, dated from the child in front of you · v1.8- Enter the child's date of birth or current age, then select NIS or IAP.
- You get the full schedule with the milestones already passed muted, the vaccines now due highlighted, and the teaching points for each.
- Record which schedule you worked from. NIS and IAP disagree on what counts as a complete course.
- Read the immunisation card before you act on the list. The tool cannot know what this child has actually received.
- Anybody past their eighteenth birthday. It schedules routine immunisation from birth to 18 years and refuses an age beyond that.
- Post-exposure prophylaxis, travel vaccines and maternal immunisation.
- A catch-up plan built for one child from a partial card. It prints the interruption rule and the standard minimum intervals, and works from the date of birth alone.
1. Child Age Parameters
2. Which Schedule to Follow
Clinical Pearls & Protocols
1. Mnemonics
Freeze-Sensitive Vaccines (Do NOT Freeze):
Remember: "Never Freeze P-H-D"
• P: Pentavalent, PCV, Polio (IPV/fIPV)
• H: Hepatitis B, Hib
• D: DPT, DTaP, Td
Mechanism: Freezing destroys the aluminium hydroxide adjuvant lattice irreversibly. Perform the Shake Test against a known frozen control to detect compromised vials.
Remember: "Never Freeze P-H-D"
• P: Pentavalent, PCV, Polio (IPV/fIPV)
• H: Hepatitis B, Hib
• D: DPT, DTaP, Td
Mechanism: Freezing destroys the aluminium hydroxide adjuvant lattice irreversibly. Perform the Shake Test against a known frozen control to detect compromised vials.
Live Attenuated Vaccines (Avoid in severe immunocompromise):
Remember: "B-R-O-M-J"
• BCG
• Rotavirus
• OPV
• Measles / MR / MMR / Mumps / Varicella
• Japanese Encephalitis (live variant)
Two or more injectable live vaccines must be given either on the same day or separated by a minimum of 4 weeks to prevent immune interference.
Remember: "B-R-O-M-J"
• BCG
• Rotavirus
• OPV
• Measles / MR / MMR / Mumps / Varicella
• Japanese Encephalitis (live variant)
Two or more injectable live vaccines must be given either on the same day or separated by a minimum of 4 weeks to prevent immune interference.
Birth Dose Mnemonic: "BOH"
• BCG
• OPV-0 (Zero dose)
• Hepatitis B Birth Dose (within 24 hours)
Delay beyond 24 hours significantly reduces efficacy in preventing vertical (mother-to-child) transmission.
• BCG
• OPV-0 (Zero dose)
• Hepatitis B Birth Dose (within 24 hours)
Delay beyond 24 hours significantly reduces efficacy in preventing vertical (mother-to-child) transmission.
2. The Pentavalent Target Diseases
The liquid Pentavalent vaccine (DTwP-HepB-Hib) covers five diseases in one injection. Each of them still kills children in India, and each is preventable.
| Component | Antigen Type | Classic Illness Script (Clinical Presentation) | Indian Context / Burden |
|---|---|---|---|
| Diphtheria | Toxoid | Low-grade fever, severe sore throat, adherent grey pseudomembrane bleeding on scraping, 'bull neck' (lymphadenopathy), myocarditis. | Resurgence noted. 968 cases reported nationally (HMIS 2021-22). Outbreaks shifting to older adolescents with waning immunity. |
| Pertussis | Whole-Cell (Killed) | Coryza followed by paroxysmal staccato cough, high-pitched inspiratory 'whoop', post-tussive emesis. Extreme leukocytosis (>20,000/μL). | High morbidity in unimmunised infants. Apnoea (not cough) is the primary presentation in neonates. |
| Tetanus | Toxoid | Descending spastic paralysis, trismus (lockjaw), risus sardonicus, opisthotonos. Preserved sensorium throughout. | Maternal & Neonatal Tetanus officially eliminated in India (2016). Risk persists in unvaccinated adults with contaminated wounds. |
| Hepatitis B | Recombinant (HBsAg) | Insidious jaundice, hepatomegaly, elevated AST/ALT. High risk of chronicity if acquired perinatally (>90%). | Endemic. 3 to 4% chronic carrier rate. Leading cause of hepatocellular carcinoma in India. |
| Hib | Conjugate Polysaccharide | Acute bacterial meningitis, acute epiglottitis (drooling, stridor, tripod position), pneumonia, septic arthritis. | Historically the leading cause of bacterial meningitis in Indian children under 5 years. |
3. Administration Route & Site Matrix
Practice advisory: Never give an intramuscular vaccine in the gluteal region of an infant. Absorption through deep gluteal fat is erratic and the sciatic nerve is close, which is why the anterolateral mid-thigh is the only acceptable IM site for children under 3 years. It is still done in Indian practice, usually by staff who were taught it that way.
| Route | Vaccines / Therapeutics | Exact Site & Technique |
|---|---|---|
| Intradermal (ID) | BCG, fIPV | BCG: Left upper arm (tubercle syringe). fIPV: Right upper arm. Technique: 15° angle, bevel up. Must produce a distinct pale wheal (peau d'orange). |
| Intramuscular (IM) | Pentavalent, PCV, HepB, DPT Boosters, Td, Tdap, TCV, IPV, HPV | Infants/Toddlers: Anterolateral mid-thigh (Vastus lateralis). Older Children (>3y): Deltoid muscle. Technique: 90° angle. Deep into the muscle bulk. Needle gauge: 23-25G. |
| Subcutaneous (SC) | MR / MMR, JE, Varicella | MR: Right upper arm. JE: Left upper arm. Technique: 45° angle into pinched subcutaneous tissue. |
| Oral | OPV, Rotavirus (RVV), Vitamin A, Albendazole | Oral mucosa. Pearl: For young children (1-3 yrs), Albendazole tablets MUST be crushed and mixed with safe water to prevent choking. If an infant regurgitates the OPV/RVV dose immediately, repeat after 5 minutes. |
4. NIS vs IAP Schedule: Key Differences
Clinical Context: The NIS is the government schedule under the Universal Immunization Programme: free, public sector, built to protect a population rather than an individual child. The IAP schedule is written for private practice and carries vaccines the NIS does not: typhoid, influenza, hepatitis A, varicella. Neither is a corrected version of the other. Record which one you have used, because it decides what counts as a complete schedule.
| Feature | NIS (Government) | IAP (Private Sector) |
|---|---|---|
| Polio Strategy | OPV + 3 fractional IPV doses (6wk, 14wk, 9m) | Full-dose IPV at 6, 10, 14 wk + boosters; OPV as per NIS campaigns |
| DPT Type | Whole-cell pertussis (DTwP) in Pentavalent | DTwP or DTaP; DTaP (acellular) has less reactogenicity but potentially shorter duration of immunity |
| Typhoid | Not in NIS | TCV from 6 to 9 months (catch-up to 15 yr) |
| Measles/Mumps | MR only (Measles-Rubella) | MMR at 9 months, 15 months, 4 to 6 years (Adds Mumps protection) |
| Influenza | Not in NIS | Annual from 6 months; 2 doses 4 wk apart for first-time recipients under 9 yr |
| Hepatitis A | Not in NIS | 2 doses: 12 months + 18 months (killed vaccine) |
| Varicella | Not in NIS | 2 doses: 15 months + 4 to 6 years |
| HPV | The national HPV vaccination campaign was launched on 28 February 2026, giving a single dose of Gardasil-4 free to girls aged 14, and continuing on routine immunisation days (PIB press release, 28 February 2026) | All adolescents 9 to 14 yr; 2 doses, 6 months apart |
5. AEFI: Adverse Events Following Immunisation
Mandatory Reporting: All serious AEFIs must be reported within 24 hours to the District Immunization Officer (DIO) and entered into the cMhealthApp/AEFI module. Do not dismiss parental AEFI concerns. Document in full.
| AEFI Type | Examples | Action |
|---|---|---|
| Minor (Expected) | Local pain/swelling, low-grade fever (<38.5°C), irritability for 24 to 48 hours | Reassure parents. Paracetamol 10 to 15 mg/kg PRN. NOT a contraindication to future doses. |
| Severe (Non-Serious) | High fever (>39°C), excessive crying (>3 hours), large local reaction (>5 cm) | Document. Symptomatic management. Consider DTaP for future DPT doses if whole-cell caused the reaction. |
| Serious | Anaphylaxis (within 30 min), HHE (Hypotonic-Hyporesponsive Episode), intussusception (post-RVV), BCG-osis | MANDATORY AEFI REPORT. Manage anaphylaxis per protocol (IM Adrenaline 0.01 ml/kg of 1:1000). Hospital admission. |
6. Catch-Up Rules & Cold Chain Integrity
The Interruption Rule: Never restart a delayed vaccine series. Immunological memory does not lapse, so pick the schedule up where it stopped and keep the standard minimum intervals between doses.
Key Catch-Up Intervals:
• Minimum interval between primary Pentavalent/OPV/RVV doses: strictly 4 weeks. Giving it earlier invalidates the dose.
• Rotavirus upper limits: First dose must not be initiated after 14 weeks 6 days. Series must be completed by 1 year of age.
• Freeze Warning: Pentavalent, HepB, Td, DPT, PCV, and IPV are adsorbed on aluminium adjuvants. The mechanism and the shake test are in section 1.
• Open Vial Policy: Opened multi-dose liquid vaccines (OPV, HepB, DPT, Td, Pentavalent, PCV) can be used for up to 28 days if stored at +2 to +8 °C with VVM intact. Reconstituted lyophilised vaccines (BCG, MR, JE) must be discarded within 4 hours.
• Minimum interval between primary Pentavalent/OPV/RVV doses: strictly 4 weeks. Giving it earlier invalidates the dose.
• Rotavirus upper limits: First dose must not be initiated after 14 weeks 6 days. Series must be completed by 1 year of age.
• Freeze Warning: Pentavalent, HepB, Td, DPT, PCV, and IPV are adsorbed on aluminium adjuvants. The mechanism and the shake test are in section 1.
• Open Vial Policy: Opened multi-dose liquid vaccines (OPV, HepB, DPT, Td, Pentavalent, PCV) can be used for up to 28 days if stored at +2 to +8 °C with VVM intact. Reconstituted lyophilised vaccines (BCG, MR, JE) must be discarded within 4 hours.
7. Claims Made for Newer Vaccines
What the evidence supports:
• DTaP vs DTwP: DTaP is marketed as "painless", but the evidence shows DTwP (whole-cell) confers more durable immunity. DTaP is acceptable but not automatically superior. Counsel parents objectively.
• Combination vaccines: Hexavalent/pentavalent combinations reduce injection burden but are significantly more expensive. Choose based on family affordability, not marketing incentives.
• Unnecessary boosters: There is no evidence for annual Typhoid "booster" shots marketed by some vaccine manufacturers. TCV provides protection for at least 5 years with a single dose.
• DTaP vs DTwP: DTaP is marketed as "painless", but the evidence shows DTwP (whole-cell) confers more durable immunity. DTaP is acceptable but not automatically superior. Counsel parents objectively.
• Combination vaccines: Hexavalent/pentavalent combinations reduce injection burden but are significantly more expensive. Choose based on family affordability, not marketing incentives.
• Unnecessary boosters: There is no evidence for annual Typhoid "booster" shots marketed by some vaccine manufacturers. TCV provides protection for at least 5 years with a single dose.
8. What This Tool Does Not Print
- A contraindication check for the child in front of you. It takes a date of birth and a schedule, and nothing about immune status or allergy.
- Anything that turns on the child's sex. It is not asked for, so the HPV rows print both positions.
- An AEFI report. Section 5 gives the duty and the destination; the form is the cMhealthApp AEFI module.
Abbreviations: ACVIP (Advisory Committee on Vaccines and Immunization Practices) · AEFI (Adverse Event Following Immunization) · ALT (Alanine Aminotransferase) · AST (Aspartate Aminotransferase) · BCG (Bacille Calmette-Guérin) · DIO (District Immunization Officer) · DPT (Diphtheria, Pertussis, Tetanus) · DTaP (Diphtheria, Tetanus and acellular Pertussis) · DTwP (Diphtheria, Tetanus and whole-cell Pertussis) · fIPV (Fractional Inactivated Polio Vaccine) · GA4 (Google Analytics 4) · HBIG (Hepatitis B Immunoglobulin) · HBsAg (Hepatitis B Surface Antigen) · HepA (Hepatitis A) · HepB (Hepatitis B) · HHE (Hypotonic-Hyporesponsive Episode) · Hib (Haemophilus influenzae type b) · HMIS (Health Management Information System) · HPV (Human Papillomavirus) · IAP (Indian Academy of Pediatrics) · ID (Intradermal) · IgG (Immunoglobulin G) · IM (Intramuscular) · IPV (Inactivated Polio Vaccine) · JE (Japanese Encephalitis) · MMR (Measles, Mumps, Rubella) · MR (Measles-Rubella) · NDD (National Deworming Day) · NIS (National Immunization Schedule) · OPV (Oral Polio Vaccine) · PCV (Pneumococcal Conjugate Vaccine) · PRN (As Required) · RV1 (Monovalent Rotavirus Vaccine) · RV116E (Rotavirus Vaccine, 116E Strain) · RV5 (Pentavalent Rotavirus Vaccine) · RVV (Rotavirus Vaccine) · SBAR (Situation, Background, Assessment, Recommendation) · SC (Subcutaneous) · TCV (Typhoid Conjugate Vaccine) · Td (Tetanus and adult Diphtheria) · Tdap (Tetanus, Diphtheria and acellular Pertussis) · TT (Tetanus Toxoid) · UIP (Universal Immunization Programme) · Vi (Virulence Capsular Polysaccharide Antigen) · VVM (Vaccine Vial Monitor)
References
- Ministry of Health and Family Welfare, Government of India. Universal Immunization Programme: National Immunization Schedule. Immunization Division, MoHFW; 2024.
- Indian Academy of Pediatrics, Advisory Committee on Vaccines and Immunization Practices (ACVIP). IAP Guidebook on Immunization 2023-2025. Eds: Kasi SG, et al. New Delhi: Jaypee Brothers; 2024.
- Ministry of Health and Family Welfare. Immunization Handbook for Medical Officers. Government of India; 2017 (updated 2022).
- World Health Organization. WHO Recommendations for Routine Immunization - Summary Tables. Geneva: WHO; 2024.
- National Technical Advisory Group on Immunization (NTAGI), India. Recommendations on PCV and HPV Introduction in UIP. MoHFW; 2023.
How to Cite This Tool
DOIhttps://doi.org/10.5281/zenodo.22401659
AMA Style:Umakanth S. Paediatric Immunisation Scheduler. Version 1.8. MEDiscuss Clinical Decision Support System. Published 2026. Accessed . https://mediscuss.org/cdss/uip-schedule. doi:10.5281/zenodo.22401659
Vancouver Style:Umakanth S. Paediatric Immunisation Scheduler [Internet]. Version 1.8. MEDiscuss.org; 2026 [cited ]. Available from: https://mediscuss.org/cdss/uip-schedule. doi:10.5281/zenodo.22401659
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Category Immunisation & ProphylaxisScheduler
Specialties Pediatrics, Immunology