Guides · 予防接種 · yobō sesshu
Vaccinations in Japan — The Schedule, the Gaps, and How to Sync With Home
Japan's vaccination system is thorough, free where it matters, and — for families arriving from abroad — just different enough from Western schedules to cause real confusion. The differences are manageable once you understand the system's one big split.
Routine vs voluntary: the split that explains everything
Every vaccine in Japan is either routine (定期接種, teiki sesshu) — nationally recommended, scheduled, and free for the target age group, administered at ordinary pediatric clinics using vouchers from your municipality — or voluntary (任意接種, nin'i sesshu) — available but paid out of pocket (typically ¥5,000–10,000 per dose) unless your municipality subsidizes it.
"Voluntary" is a fiscal category, not a medical judgment: some vaccines in it are ones pediatricians strongly recommend. Do not read 任意 as "unnecessary."
Routine (free) for children currently includes: hepatitis B, rotavirus, Hib, pneumococcal (PCV), the pentavalent/DPT-IPV combination, BCG (tuberculosis), MR (measles-rubella), varicella (chickenpox), Japanese encephalitis, and HPV. The notable members of the voluntary (paid) list: mumps (usually two doses, often municipally subsidized) and seasonal influenza for children (also frequently subsidized).
What's different from what you knew at home
Coming from North America, Europe, or Australia, these are the differences worth registering:
- No MMR. Japan gives MR (measles-rubella) and handles mumps separately as a paid voluntary vaccine. If you do nothing beyond the default schedule, your child will not be vaccinated against mumps. Most pediatricians recommend adding it; many municipalities subsidize it. This is the single most consequential "gap" for foreign families — opt in.
- BCG is routine (given in infancy, the distinctive 9-point stamp on the upper arm) — many Western countries dropped it decades ago. Conversely, a BCG-vaccinated child may later trip positive on tuberculin skin tests abroad; IGRA blood tests avoid the confusion.
- Japanese encephalitis vaccine is routine here and unfamiliar to most Western parents; it protects against a mosquito-borne virus present in East Asia. If you live here, take it.
- HPV is routine and free for girls (school year 6 through the first year of high school). For boys it remains voluntary, with a growing number of municipalities offering subsidies — worth checking your city's website, and worth doing.
- Timing details differ (interval rules, combination products), which matters mainly when merging records — see below.
For adults: influenza and COVID-19 vaccines are routine (partly subsidized) for those 65 and over, and paid voluntary otherwise, widely available each autumn at clinics — no appointment systems more complicated than a phone call. Adults born in eras of one-dose measles schedules, or men in the Japanese birth cohorts that never received rubella vaccination, should consider an MR catch-up — especially before a first pregnancy in the household.
The practical machinery
Everything runs through your municipality and the Boshi Techō (Mother and Child Handbook). After you register residence with a child, the city mails a booklet of vaccination vouchers (予診票). You book an ordinary pediatric clinic, bring handbook and vouchers, and the clinic records each dose in the handbook. No central online portal, no school-entry enforcement drama — the handbook is the record, which is why guarding it matters.
Two rules of engagement at the clinic: vaccinations are usually given at dedicated times or by appointment (call first), and a light fever or cold on the day will get the appointment rescheduled — Japanese practice is conservative about vaccinating sick children.
Arriving mid-schedule: merging two countries' records
This is the most common real-world task and it is very solvable:
- Bring written records from home (the yellow WHO booklet, a clinic printout — anything dated and named).
- Have them transcribed into the Boshi Techō — your pediatrician or the municipal health center will do this; a translation of vaccine names helps but brand names are usually decipherable.
- The pediatrician then maps your child onto the Japanese schedule, counting foreign doses toward Japanese requirements where equivalent. Doses do not "reset" — nobody revaccinates from zero.
- Going the other direction (leaving Japan), ask the clinic for an English vaccination certificate (英文の予防接種証明書) — most produce one for a small fee, and schools abroad accept the format.
One warning specific to arrivals: eligibility windows for routine vaccines are age-based, and if a window is missed the vaccine can shift to paid-voluntary status. Municipalities grant catch-up provisions in many cases — go to the health center (保健センター) counter early rather than assuming a missed window is closed.
General information: the schedule is revised regularly and municipal subsidies differ. Your pediatrician and your city's health center are the authoritative pair — and both deal with mid-schedule international arrivals far more often than you would guess.