Childhood Vaccination Schedule: Which Vaccine and When?

The childhood vaccination schedule is a timeline of vaccines administered from infancy to school age to provide immunity against life-threatening diseases such as diphtheria, whooping cough, measles, and polio. Starting at birth, this process involves an intensive vaccination programme during the first two years, while booster doses given during the school years ensure lifelong protection. Timely and complete vaccinations are the most reliable way to protect not only your child but the entire community from infectious disease outbreaks.

• The Ministry of Health vaccination schedule protects children against 13 different fatal or disabling diseases.
• The order of vaccines for babies begins with the first dose of the Hepatitis B vaccine, administered immediately after birth.
• The measles, mumps, and rubella (MMR) vaccine is given at the end of the 12th month and in the 1st grade of primary school.
• Mild fever, fussiness, and redness at the injection site are expected, temporary side effects after vaccination.
• Declining vaccination rates in Europe are causing forgotten diseases like measles to spread once again.

Why is the Vaccination Schedule Vitally Important?

Vaccines contain weakened or killed microorganisms that train the body's immune system. This allows the body to immediately recognise the actual disease-causing virus or bacterium and destroy it before symptoms appear. In recent years, declining vaccination rates in Europe and various parts of the world have led to diseases like measles and whooping cough—which were previously under control—turning into outbreaks once again. This situation demonstrates just how critical it is to strictly follow the vaccination schedule.

Considering the increase in respiratory tract infections during the winter months and threats like the RSV virus, keeping children's general immune systems strong is essential. Vaccines form the building blocks of the immune system. By vaccinating your own child, you not only protect them but also contribute to the community immunity shield that protects babies undergoing cancer treatment or those who are too young to be vaccinated.

The Order of Vaccines for Babies and the First Two Years Schedule

The order of vaccines for babies is meticulously planned according to the developmental stages of the baby's immune system and the months they are most vulnerable to diseases. According to the Turkish Ministry of Health schedule, the process begins in the delivery room and continues at specific intervals until the 24th month. The first two years are the most intensive period when foundational immunity is established.

At birth, the baby is given the first dose of the Hepatitis B vaccine. At the end of the first month, the second dose of Hepatitis B is administered. The second month is one of the busiest months of the vaccination schedule; during this month, the first doses of the Tuberculosis (BCG), 5-in-1 Combination Vaccine (Diphtheria, Tetanus, Pertussis, Polio, Hib), and Pneumococcal Conjugate (PCV) vaccines are administered. In the fourth month, the second doses of the 5-in-1 Combination and PCV vaccines are given. By the sixth month, in addition to the third doses of Hepatitis B, the 5-in-1 Combination, and PCV, the Oral Polio Vaccine (OPV) is given as drops.

When the baby reaches one year of age (12th month), the Measles, Mumps, Rubella (MMR), Chickenpox (Varicella), and the final booster dose of PCV are administered. At 18 months, the booster dose of the 5-in-1 Combination vaccine, Polio drops, and the first dose of the Hepatitis A vaccine are given. At 24 months, the second dose of the Hepatitis A vaccine is administered, completing the basic vaccination programme of infancy.

School-Age Vaccines and Booster Doses

Some of the immunity gained during infancy may weaken over the years. Therefore, school-age vaccines play a critical role in ensuring that protection lasts a lifetime. When children start school, their risk of infection increases as they spend time in crowded groups in enclosed spaces. In the 1st grade of primary school (usually between ages 4-6), the second dose of the Measles, Mumps, Rubella (MMR) vaccine and the 4-in-1 Combination Vaccine (Diphtheria, Tetanus, Pertussis, Polio) are administered.

During middle school, in the 8th grade (usually ages 13-14), a booster dose of the Tetanus and Diphtheria (Td) vaccine is given. Just as it is necessary to pay attention to hygiene during the school period and instil hand-washing habits, completing missing vaccines is the most direct way to prevent classroom outbreaks. School vaccines are generally tracked at Family Health Centres (Aile Sağlığı Merkezleri) in Türkiye, and families are informed when it is time.

Mandatory Vaccines for Children and the Ministry of Health Schedule

In Türkiye, mandatory vaccines for children are provided free of charge under the Ministry of Health's Expanded Programme on Immunisation. This schedule is prepared taking into account the up-to-date data of the World Health Organization (WHO) and the country's epidemiological structure. The national vaccination schedule covers a total of 13 dangerous diseases: whooping cough, diphtheria, tetanus, measles, mumps, rubella, tuberculosis, polio, chickenpox, hepatitis A, hepatitis B, pneumococcal disease (pneumonia), and Haemophilus influenzae type b (Hib).

Apart from this routine schedule, there are also special vaccines recommended by paediatricians but not yet included in the national free schedule. The Rotavirus vaccine (a cause of severe diarrhoea) and Meningococcal vaccines (a cause of meningitis) fall into this group. Medical authorities strongly recommend that these vaccines also be administered during infancy, at the weeks determined by your doctor, to protect children from these severe infections.

Post-Vaccination Side Effects and Home Care

Vaccines are highly safe biological products, but because they stimulate the immune system, they can cause some mild and temporary side effects. Within the first 24 to 48 hours after vaccination, your baby may experience a mild fever between 37.5 and 38 degrees Celsius, loss of appetite, sleeping more than usual, or fussiness. Mild swelling, redness, and tenderness on the vaccinated leg or arm are also expected.

During the home care process, breastfeeding your baby frequently or increasing fluid intake will be soothing. You should strictly avoid applying cologne or alcohol to the injection site or rubbing the area. You can apply a gentle compress to the reddened area using a clean, cold cloth. If the fever exceeds 38 degrees Celsius or if your child is very restless, you can use paracetamol-containing antipyretic syrups at the dose previously recommended by your doctor. The use of aspirin to reduce fever in children is strictly prohibited.

Community Immunity and the Risks of Anti-Vaccination

When a sufficient number of people in a community are vaccinated, disease-causing microbes cannot find a host to jump from person to person, and the chain of outbreak is broken. This is called community immunity (herd immunity). For example, to prevent the measles virus from spreading in society, at least 95 percent of the population must be vaccinated. When vaccination rates fall below this threshold, the virus quickly finds an opportunity to spread.

In recent years, cases of vaccine refusal based on misinformation have endangered not only unvaccinated children but also individuals who cannot be vaccinated for medical reasons. Children undergoing leukaemia treatment, patients who have had organ transplants, or newborn babies whose vaccination schedules are not yet complete rely on the vaccinated healthy individuals around them to survive. Adhering to the vaccination schedule is more than an individual health choice; it is a social responsibility.

When to See a Doctor?

Mild symptoms seen after vaccination usually disappear on their own within 48 hours. However, in rare cases, medical intervention may be required. If you observe any of the following symptoms, you should consult your doctor without delay or go to the nearest emergency department:

• Persistent fever that does not drop to 39 degrees Celsius or below despite giving fever-reducing medication.
• The baby crying with a high-pitched, inconsolable voice for more than three hours.
• Widespread rash, severe itching, or hives all over the body.
• Immobility, excessive sleepiness, or unresponsiveness to surroundings.
• Signs of a seizure (convulsion) such as eyes rolling back or muscle spasms.

If symptoms of anaphylaxis (a severe allergic reaction) such as difficulty breathing, wheezing, or swelling of the face, lips, or throat occur immediately after the vaccine, you must call the 112 emergency call centre without waiting.

The Vaccination and Well-Child Tracking Process at BHT CLINIC

At the BHT CLINIC İstanbul Tema Hastanesi Paediatrics department, the growth, development, and vaccination tracking of all children from the newborn period up to age 18 are meticulously carried out by our specialist physicians. In our JCI-accredited hospital, the cold chain rules, which are vital for maintaining the efficacy of vaccines, are continuously monitored via digital systems.

During the examination, your child's overall physical development is evaluated, past vaccination records are reviewed, and required vaccines are administered in a safe environment. When coming in for a vaccination, simply bringing your child's vaccination card is sufficient. Against any rare reactions that may develop after vaccination, our fully equipped emergency department and expert staff, providing 24/7 service, are always by your side.

Frequently Asked Questions

What should I do if my baby's vaccine is delayed?

There is no need to worry if a vaccination date is delayed due to an illness or a special circumstance. The vaccination schedule does not start over from the beginning; your doctor will create a new catch-up schedule to continue from where you left off. The important thing is to complete the missing vaccines as soon as possible.

Is it harmful to have more than one vaccine on the same day?

There is no evidence that administering multiple vaccines on the same day exhausts the immune system. Babies' immune systems have the capacity to handle thousands of antigens every day. Provided they are administered in different areas (for example, the right and left leg), it is completely safe to administer multiple vaccines at the same time.

Can my child be vaccinated if they have a mild cold?

A mild runny nose, cough, or low-grade fever below 38 degrees Celsius are not obstacles to vaccination. Your child can be vaccinated even if they are taking antibiotics. However, if there is a high fever and a severe infection, your doctor may decide to postpone the vaccine for a few days.

Should special vaccines (Rotavirus, Meningococcal) be administered?

Rotavirus and Meningococcal vaccines, which are not in the Ministry of Health schedule but are recommended by paediatricians, protect children from severe cases of diarrhoea and meningitis. Since these diseases can be serious enough to require hospitalisation, it is medically recommended that special vaccines also be administered according to the schedule.

Can I bathe my child after a vaccination?

There is no harm in bathing your child after most vaccines. However, after the Tuberculosis (BCG) vaccine is administered, it is recommended not to bathe the child for the first three days so that the injection site does not come into contact with water. For other vaccines, a bath can soothe the child, especially in the case of a mild fever.

You can book an appointment with our specialist physicians to plan your child's vaccination schedule, complete missing vaccines, and for well-child tracking. For emergencies and detailed information, you can reach us 24/7 through our call centre at 0850 811 34 00.

This article is for informational purposes only; please be sure to consult your doctor for diagnosis and treatment.