If you’re raising a baby in Japan — or visiting with a young infant — understanding the vaccination system here is essential. Japan’s schedule differs from what many Western parents are used to, and knowing what to expect can help you stay on track and advocate for your child’s health.
- How Japan’s Vaccination System Works
- Japan’s Routine Vaccination Schedule (Birth to 12 Months)
- Japan vs. US Vaccination Schedule: Key Differences
- Voluntary Vaccines Worth Considering in Japan
- Getting Vaccinations in Japan as a Foreign Family
- Keeping Track: Your Baby’s Vaccination Record
- Frequently Asked Questions
- Disclaimer
How Japan’s Vaccination System Works
Japan divides vaccines into two categories:
Routine vaccinations (定期接種): Covered by your local municipal government — essentially free. These are the core vaccines recommended for all children and are recorded in your child’s Boshi Techo (母子手帳), Japan’s Maternal and Child Health Handbook.
Voluntary vaccinations (任意接種): Not covered by the government (or only partially subsidized depending on your municipality). You pay out of pocket, though some local governments offer subsidies — it’s worth checking with your local ward or city office.
The Boshi Techo and Vaccinations
If you have a Boshi Techo, you’ll notice it has a dedicated vaccination record section. Every time your baby receives a vaccine in Japan, the date and lot number are recorded there. This booklet is your child’s official health and vaccination record in Japan — keep it safe and bring it to every appointment.
Japan’s Routine Vaccination Schedule (Birth to 12 Months)
Recommended vaccinations in Japan start at 2 months of age. Here’s what the schedule looks like in the first year:
| Age | Vaccine | Type | Notes |
|---|---|---|---|
| Birth | Hepatitis B (HBV) ① | Inactivated | Given at birth if mother is HBs antigen positive; otherwise starts at 2 months |
| 2 months | DPT-IPV-Hib (5-in-1) ① | Inactivated | Diphtheria, Pertussis, Tetanus, Polio, Hib |
| 2 months | Pneumococcal (PCV) ① | Inactivated | |
| 2 months | Rotavirus ① | Live (oral) | Choose Rotarix (2 doses) or RotaTeq (3 doses) |
| 2 months | Hepatitis B ① | Inactivated | |
| 3 months | DPT-IPV-Hib ② | Inactivated | |
| 3 months | PCV ② | Inactivated | |
| 3 months | Rotavirus ② | Live (oral) | |
| 3 months | Hepatitis B ② | Inactivated | |
| 4 months | DPT-IPV-Hib ③ | Inactivated | |
| 4 months | PCV ③ | Inactivated | |
| 4 months | Rotavirus ③ | Live (oral) | RotaTeq only; final dose for Rotarix was at 3 months |
| 5–8 months | BCG | Live | One notable difference is that Japan still includes BCG (tuberculosis vaccine) as a routine childhood vaccination, unlike many Western countries. |
| 6–7 months | Hepatitis B ③ | Inactivated | Final dose |
| 12–15 months | MR (Measles/Rubella) ① | Live | |
| 12–15 months | Varicella (Chickenpox) ① | Live | |
| 12–15 months | PCV ④ | Inactivated | Booster |
One of the biggest differences you’ll notice is BCG (tuberculosis vaccine). BCG is still one of the routine vaccines in Japan, because the number of tuberculosis patients ranks higher than in North America and Western Europe, where BCG is no longer provided.
In Japan, BCG is given between 5 and 8 months of age. It leaves a small scar on the upper arm — this is normal and expected.
Japan vs. US Vaccination Schedule: Key Differences
| Vaccine | Japan | USA (CDC 2025) |
|---|---|---|
| BCG | ✅ Routine (5–8 months) | ❌ Not routine |
| Hepatitis B | ✅ Routine (mainly 2/3/7 months) | ✅ Routine (birth/1–2/6–18 months) |
| DPT-IPV-Hib (5-in-1) | ✅ Routine from 2 months | ✅ Similar combination from 2 months |
| Rotavirus | ✅ Routine (2–4 months) | ✅ Routine (2–6 months) |
| Pneumococcal (PCV) | ✅ Routine from 2months | ✅ Routine |
| MMR / MR | ✅ MR only (Measles + Rubella) | ✅ MMR (Measles + Mumps + Rubella) |
| Mumps | Voluntary only | ✅ Included in MMR (routine) |
| Varicella | ✅ Routine (12 months+) | ✅ Routine (12–15 months) |
| Hepatitis A | Not routine | ✅ Routine (12–23 months) |
| Japanese Encephalitis | ✅ Routine (3 years+) | Not routine (travel vaccine only) |
| Influenza | Recommended annually from 6 months | ✅ Recommended annually from 6 months |
The Mumps Difference
One of the most notable differences: mumps vaccine is not included in Japan’s routine schedule. In the US, mumps is covered as part of the MMR (Measles, Mumps, Rubella) combination vaccine given at 12–15 months.
In Japan, measles and rubella are combined as MR, but mumps is a voluntary vaccine — meaning you pay for it separately. Many families in Japan choose to get it, but it’s not automatic. If you’re coming from the US, check whether your child has already received MMR and discuss with your pediatrician.
※Update in 2026: In May 2026, Japan approved a new domestic MMR vaccine, Mimrit, manufactured by Daiichi Sankyo. This was an important step because Japan had not had a domestically approved MMR vaccine for roughly 30 years.
However, approval does not automatically mean that MMR has become part of the national routine immunization schedule. As of now, MR remains the routine vaccine in Japan, while mumps vaccination has traditionally been voluntary. Parents should check with their pediatrician or local municipality for the latest availability, cost, and schedule.
Hepatitis A
The US includes Hepatitis A as a routinely recommended vaccine starting at 12 months. Japan does not — it’s considered a voluntary vaccine here.
Voluntary Vaccines Worth Considering in Japan
Even though these aren’t covered by the government, many pediatricians recommend them:
| Vaccine | Why it matters |
|---|---|
| Mumps | Not included in routine MR vaccine in Japan |
| Influenza | Recommended annually, especially for babies under 1 |
| Hepatitis A | Routine in the US but voluntary in Japan |
Talk to your pediatrician about which voluntary vaccines make sense for your child.
Getting Vaccinations in Japan as a Foreign Family
Do You Need Japanese Health Insurance?
For routine vaccinations, you do not need to be enrolled in Japanese health insurance — you need to be registered as a resident in your municipality. Foreign residents registered at the local ward or city office are entitled to the same routine vaccinations as Japanese citizens.
Language Support
Many major cities have multilingual support for vaccination appointments. Tokyo, Osaka, and other large cities often have English-speaking pediatricians and multilingual vaccination pamphlets available through your local ward office.
Vaccination Vouchers (予防接種票)
After registering your baby at the local ward office, you’ll receive vaccination vouchers (予防接種票) by mail. Bring these to every appointment — they’re required to receive free routine vaccinations.
Keeping Track: Your Baby’s Vaccination Record
The Boshi Techo has a dedicated section for vaccination records. Every vaccine your baby receives in Japan — routine and voluntary — should be recorded here with the date, vaccine name, and lot number.
If you’re moving back to your home country, bring the Boshi Techo and request an English summary of your child’s vaccination history from your pediatrician. This will make it much easier to continue care abroad.
Frequently Asked Questions
My baby was vaccinated in the US before coming to Japan. Do we need to start over?
No. Bring your child’s vaccination records from the US to your Japanese pediatrician. They will review what has been given and create a catch-up plan for any vaccines that differ from the Japanese schedule. You don’t need to repeat vaccines already received.
Is the 5-in-1 vaccine (DPT-IPV-Hib) the same as in the US?
Similar, but not identical. As of April 1, 2024, a combination of Diphtheria, Pertussis, Tetanus, Polio, and Hib (DPT-IPV-Hib, 5-in-1) became a routine vaccination in Japan, replacing the previous 4-in-1 vaccine. The US uses a similar combination (DTaP-IPV-Hib).
What if my baby misses a scheduled vaccine?
Don’t panic — catch-up vaccination is possible. Talk to your pediatrician as soon as you notice a missed vaccine. Japan has catch-up schedules available for most vaccines.
Can I get MMR instead of MR in Japan?
The MMR (including mumps) is not routinely available in Japan as a combined vaccine in the same way as in the US. You would need to give MR (routine) and mumps (voluntary) separately. Ask your pediatrician for guidance.
Are vaccines safe for babies with allergies?
Always inform your pediatrician of any allergies before vaccination. Most children with egg allergies can safely recieve influenza vaccines, but always discuss any allergies with your pediatrician beforehand.
Can babies receive multiple vaccines at the same visit?
Yes. In Japan, it is common for babies to receive several vaccines during a single appointment. This helps complete the vaccination schedule on time and is considered safe by Japanese pediatric societies.
Disclaimer
This article is based on our personal experience and understanding of Japan’s vaccination system as parents living in Japan.
Vaccination schedules, recommendations, government subsidies, and local policies may change over time and can vary between municipalities.
Always consult your pediatrician, local health center, or municipal office for the most up-to-date information regarding your child’s vaccinations.
This article is intended for informational purposes only and should not be considered medical advice.
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