Singapore's Childhood Vaccine Schedule, Explained:
Every Jab, Every Reason

Vaccination is one of the most powerful tools in medicine. Globally, vaccines prevent an estimated 4–5 million deaths every year. In Singapore, the National Childhood Immunisation Schedule (NCIS) has helped eliminate diseases that once killed or permanently disabled thousands of children annually.

And yet, every time I sit down with a new parent, there are the same questions: Why so many? Why so early? What's compulsory vs optional? And what do I do when my baby screams all evening after a jab? This guide answers all of that.

A Note on Herd Immunity

When enough people in a community are vaccinated, even those who cannot be vaccinated (newborns, immunocompromised children, those with rare allergies) are protected because the pathogen has nowhere to spread. This is herd immunity — and it only works when vaccination rates remain high. In Singapore, falling rates of any compulsory vaccine can trigger outbreaks. We saw this with measles in the early 2000s and pertussis (whooping cough) more recently.

The Full Singapore NCIS 2024 Schedule

*Compulsory component: Diphtheria (part of DTaP combo) and Measles (part of MMR). Non-compliance may result in fines under the Infectious Diseases Act.

What Each Vaccine Does — and Why It Matters

BCG (At Birth)

BCG (Bacille Calmette-Guérin) protects against tuberculosis (TB), specifically against the most severe forms — TB meningitis and disseminated TB — which are devastating in young children. It is given as a single intradermal injection in the left upper arm. Over the following 2–6 weeks, a small red bump will form, blister, and eventually leave a small scar. This is entirely expected and means the vaccine is working.

Hepatitis B (At Birth, 2 Months, 6 Months)

Hepatitis B virus causes chronic liver disease and is a leading cause of liver cancer globally. Singapore historically had a carrier rate of ~3–4% before widespread vaccination. The virus can be transmitted from an infected mother to her baby during delivery — giving the first dose within 24 hours of birth dramatically reduces this risk. Three doses complete the primary series, providing lifelong immunity in most recipients.

5-in-1 / 6-in-1 — DTaP-IPV-Hib (± HepB) — (2, 4, 6 Months + Booster at 18 Months)

This combination vaccine protects against five or six diseases in one injection — a genuine gift to babies and parents alike. The components protect against:

• Diphtheria — a bacterial toxin that can cause a membrane to form in the throat, blocking the airway. Fatal in up to 10% of cases before vaccination.
• Tetanus — muscle spasms ("lockjaw") caused by a bacterial toxin from soil. Neonatal tetanus was a major cause of newborn death in less vaccinated populations.
• Pertussis (Whooping Cough) — a violent coughing illness that can be fatal in infants under 6 months. Adults and older siblings are the usual source of infection for newborns — which is why maternal vaccination during pregnancy is also recommended.
• Polio — a viral disease that can cause permanent paralysis. Effectively eradicated in Singapore through vaccination.
• Haemophilus influenzae type b (Hib) — a leading cause of bacterial meningitis, epiglottitis, and pneumonia in young children before this vaccine existed.

PCV — Pneumococcal (2, 4, 12 Months)

The pneumococcal conjugate vaccine (PCV) protects against Streptococcus pneumoniae, a bacterium responsible for meningitis, pneumonia, septicaemia, and ear infections. Bacterial meningitis from pneumococcus can kill within hours and leaves survivors with deafness, brain damage, or limb loss. The PCV series (3 doses + 1 booster) has dramatically reduced these outcomes.

Rotavirus (2 and 4 Months — Oral)

Rotavirus is the leading cause of severe gastroenteritis (vomiting and diarrhoea) in young children worldwide. Before vaccination, it accounted for thousands of hospitalisations annually in Singapore. Uniquely, this vaccine is given orally — a few drops in the baby's mouth — not injected. Two doses complete the course. It must be given before 24 weeks of age.

MMR — Measles, Mumps, Rubella (12 Months + 18 Months)

Measles remains one of the most contagious infectious diseases known — far more contagious than COVID-19. It can cause encephalitis, blindness, and death. Mumps causes painful swollen glands and, in post-pubertal males, orchitis (testicular inflammation) that can affect fertility. Rubella in a pregnant woman causes devastating fetal defects. Two doses of MMR are required for full protection.

Varicella — Chickenpox (12 and 15 Months)

Many Singaporean parents remember chickenpox as a rite of passage — but it can cause bacterial skin infections, pneumonia, and encephalitis, particularly in immunocompromised children. Two doses provide approximately 98% protection against severe disease.

Influenza — Annual from 6 Months

The influenza vaccine needs to be given annually because the circulating strains change each year. Children in childcare and preschool settings are at highest risk of infection and transmission. Annual vaccination is strongly recommended from 6 months. Children under 9 years receiving their first-ever influenza vaccine require two doses 4 weeks apart.

Managing Post-Vaccination Reactions — Practical Guidance

Every parent wants to know: what happens after the jab, and what should I do? Here are vaccine-specific guides.