National Immunization Schedule (NIS) India — 2026 Reference
The National Immunization Schedule (NIS) is one of the highest-yield topics for UPSC CMS, NEET PG, INICET and FMGE. India's Universal Immunization Programme (UIP) covers approximately 2.65 crore newborns and 2.9 crore pregnant women every year, providing free vaccination against 12 vaccine-preventable diseases. This page consolidates the current NIS as updated through 2024.
The Universal Immunization Programme (UIP) was launched in 1985 and is one of the largest public health programmes in the world in terms of doses administered, beneficiaries covered and geographic reach. It currently protects against twelve diseases: Tuberculosis, Poliomyelitis, Diphtheria, Pertussis, Tetanus, Hepatitis B, Haemophilus influenzae type b, Rotaviral diarrhoea, Pneumococcal pneumonia, Measles, Rubella, and Japanese Encephalitis (in endemic districts).
The schedule is reviewed periodically by the National Technical Advisory Group on Immunization (NTAGI). Major additions over the last decade include the Pentavalent vaccine (2011, replacing DPT+HepB separately), Rotavirus vaccine (2016, in phases), Pneumococcal Conjugate Vaccine (PCV, 2017), Measles-Rubella (MR, 2017), and the Tetanus-Diphtheria (Td) vaccine replacing TT for older children and pregnant women.
| Vaccine | Route | Site | Dose |
|---|---|---|---|
| BCG | Intradermal | Left upper arm | 0.1 ml (0.05 ml if < 1 year) |
| OPV-0 | Oral | Mouth | 2 drops |
| Hepatitis B (birth dose) | Intramuscular | Anterolateral thigh (left) | 0.5 ml |
BCG should be given as early as possible after birth, preferably within the first 2 weeks. If given beyond 1 year of age, the dose is halved to 0.05 ml. The OPV-0 birth dose is critical — it primes mucosal immunity and is given within the first 15 days. Hepatitis B birth dose is most effective when given within 24 hours of birth to prevent perinatal transmission.
| Age | Vaccines |
|---|---|
| 6 weeks | Pentavalent-1 (DPT+HepB+Hib), OPV-1, IPV-1 (fractional dose IM, right anterolateral thigh), Rotavirus-1, PCV-1 |
| 10 weeks | Pentavalent-2, OPV-2, Rotavirus-2 |
| 14 weeks | Pentavalent-3, OPV-3, IPV-2, Rotavirus-3 (where applicable), PCV-2 |
The Pentavalent vaccine combines DPT, Hepatitis B and Hib into a single injection, reducing injection burden from 3 to 1 at each visit. It is given intramuscularly in the anterolateral thigh (never gluteal in infants due to sciatic nerve risk). IPV (Inactivated Polio Vaccine) was introduced in 2015 as a fractional intradermal dose (0.1 ml) at 6 and 14 weeks to maintain polio immunity after OPV withdrawal. Rotavirus vaccine uses a 3-dose schedule with Rotavac (Bharat Biotech) being the most widely used indigenous product.
| Age | Vaccines |
|---|---|
| 9 months (completed) | MR-1 (Measles-Rubella), PCV booster, JE-1 (in endemic districts only) |
| 15-18 months | MR-2, DPT booster-1, OPV booster, JE-2 (endemic districts) |
| 16-24 months | Vitamin A1 (2 lakh IU) |
| 5-6 years | DPT booster-2 |
| 10 years | Td (Tetanus-Diphtheria, adult type) |
| 16 years | Td |
The Measles-Rubella (MR) campaign vaccine replaced the standalone measles vaccine in 2017. A single dose of MR provides >95% protection against measles for life. The 15-18 month DPT booster is the first booster after the primary series, the second being at 5-6 years. Japanese Encephalitis vaccine is given only in 286 endemic districts across 24 states.
| Stage of Pregnancy | Vaccine | Dose |
|---|---|---|
| Early in pregnancy | Td-1 | 0.5 ml IM, upper arm |
| 4 weeks after Td-1 | Td-2 | 0.5 ml IM |
| If previously received 2 TT/Td in past 3 years | Td booster only | 0.5 ml IM |
The shift from TT (Tetanus Toxoid) to Td (Tetanus-diphtheria adult) in 2018 was made to maintain diphtheria immunity in adults as well — single-antigen TT was phased out nationally. Maternal tetanus elimination was certified by WHO in 2015 for India, and Td vaccination of pregnant women is now the principal strategy to maintain that status. The minimum interval between Td-1 and Td-2 is 4 weeks; if the woman has received 2 doses in a previous pregnancy within 3 years, only one booster is needed in the current pregnancy.
Vitamin A supplementation is given as part of the NIS to prevent childhood blindness and reduce under-5 mortality from measles and diarrhoea. The schedule is:
- 9 months (with MR-1): Vitamin A1, 1 lakh IU orally
- 16-24 months: Vitamin A2, 2 lakh IU
- Then every 6 months until 5 years of age: Vitamin A3 through A9, each 2 lakh IU
A total of 9 doses of Vitamin A should be given between 9 months and 5 years. Side effects (transient nausea, vomiting, bulging fontanelle in infants) are usually mild and self-limiting. Persistent refusal of feeds, persistent vomiting, or bulging fontanelle beyond 24 hours warrants medical evaluation.
True contraindications are rare and frequently over-diagnosed, leading to missed vaccinations. The following are true contraindications:
- Severe anaphylaxis to a previous dose of the same vaccine or a known component
- Severe immunodeficiency (for live vaccines like BCG, OPV, MR, JE) — includes symptomatic HIV, immunosuppressive therapy, malignancies
- Pregnancy (for live vaccines)
- Encephalopathy within 7 days of pertussis-containing vaccine (for subsequent DPT doses — use DT instead)
The following are NOT contraindications (frequently mistaken): mild illness, low-grade fever (< 38.5°C), malnutrition, breastfeeding, common cold, mild diarrhoea, jaundice in the newborn, history of prematurity, or family history of adverse events. Vaccination should proceed in all these situations.
The National Immunization Schedule is the single most frequently tested factual topic in PSM exams, and remembering it cold is non-negotiable for UPSC CMS, NEET PG, INICET and FMGE aspirants. Use this page as your one-stop revision sheet, but always cross-check with the latest MoHFW immunization handbook when in doubt, since minor updates occur every 1-2 years as NTAGI reviews new evidence.