National Immunization (Khop) Schedule of Nepal: Vaccine-by-Age Chart

The National Immunization Programme (NIP), popularly called khop, is the free childhood vaccination service run by the Government of Nepal. It began in 2034 BS (1977/78) as the Expanded Programme on Immunization (EPI) with a handful of vaccines and has grown into one of the country's flagship public-health efforts. It is classified as a Priority 1 (P1) programme, meaning funding and staffing are protected even during budget cuts, and it is delivered by the Family Welfare Division (FWD) under the Department of Health Services (DoHS), Ministry of Health and Population (MoHP).

Every antigen in the national schedule is provided completely free of charge at government facilities. Vaccines are delivered through more than 16,000 immunization sessions and outreach clinics across all seven provinces, from urban health posts to remote outreach points reached on foot. Because the vaccines are free, parents should never be asked to pay for any dose listed in this schedule at a public facility.

As of 2025 the routine schedule contains 14 antigens protecting against 13-plus vaccine-preventable diseases, including tuberculosis, polio, diphtheria, pertussis (whooping cough), tetanus, hepatitis B, Haemophilus influenzae type b, pneumococcal disease, rotavirus diarrhoea, measles, rubella, Japanese encephalitis, typhoid and cervical cancer. To be fully immunized, a child needs at least seven scheduled contacts with a health facility: at birth, at 6, 10 and 14 weeks, and at 9, 12 and 15 months, followed by an HPV dose in early adolescence.

The table below is the canonical khop tachalika (immunization schedule) for a healthy child in Nepal, listing each vaccine with the age it is due, the number of doses, the dose volume and the route of administration. Dose volumes follow standard WHO/EPI practice used by Nepal's programme. Print or save this chart and take it to every visit so the health worker can update your child's immunization card.

Two points often confuse parents. First, fIPV means the fractional-dose inactivated polio vaccine: only one-fifth of a full IPV dose (0.1 ml) is injected into the skin (intradermally), given alongside the oral polio drops to build stronger, longer-lasting protection. Second, the Td (tetanus-diphtheria) vaccine in this programme is for pregnant women, not the newborn: it protects both mother and baby against maternal and neonatal tetanus.

If a dose is missed, it is not lost. Take the child to the nearest health facility as soon as possible; the health worker will resume the schedule and give the pending doses without restarting the whole series.

The schedule is front-loaded because the first months of life carry the highest risk from many of these diseases. BCG (Bacillus Calmette-Guerin) is given at birth as a single 0.05 ml intradermal injection in the left upper arm to protect against severe forms of childhood tuberculosis. A small raised bump that later forms a tiny scar is the normal, expected reaction, and is not a cause for worry.

At 6, 10 and 14 weeks the child returns three times for the core infant series. At each of these visits the baby receives OPV drops (oral polio) and the Pentavalent injection, a single shot that combines protection against diphtheria, pertussis, tetanus, hepatitis B and Hib. PCV, which guards against pneumococcal pneumonia and meningitis, is given at 6 weeks, 10 weeks and again at 9 months. Rotavirus vaccine, an oral vaccine against the leading cause of severe infant diarrhoea, is given as two doses at 6 and 10 weeks.

Keeping the 6-, 10- and 14-week visits on time is the single most important thing a parent can do. Completing three doses of Pentavalent by 14 weeks (the DTP3 milestone) is the standard international marker of a fully protected infant, and Nepal has sustained high coverage of this milestone for years.

The second cluster of visits protects the toddler as maternal antibodies fade. At 9 months the child receives the first dose of Measles-Rubella (MR1) by subcutaneous injection, the third dose of PCV, and the second dose of fIPV. Measles remains one of the most contagious diseases, so this 9-month visit is critical for community protection.

At 12 months the Japanese encephalitis (JE) vaccine is given as a single 0.5 ml subcutaneous dose. JE is a mosquito-borne brain infection historically concentrated in the Terai, and the campaign-plus-routine strategy has sharply reduced cases. At 15 months two vaccines are due together: the second dose of Measles-Rubella (MR2), which boosts and consolidates immunity, and a single dose of the Typhoid Conjugate Vaccine (TCV), which protects against typhoid fever caused by contaminated food and water.

By the child's second birthday, a fully immunized Nepali child has completed BCG, three OPV, three Pentavalent, three PCV, two Rotavirus, two fIPV, two MR, one JE and one TCV dose. This is the point at which the routine infant-and-toddler schedule is complete; the next scheduled vaccine is HPV in early adolescence.

The Human Papillomavirus (HPV) vaccine is the newest antigen in Nepal's schedule and became the 14th antigen when it was introduced in 2025. Nepal launched a nationwide HPV campaign on 4 February 2025 (World Cancer Day), vaccinating over 1.46 million girls in grades 6-10 and out-of-school girls aged 10-14, reaching around 94% coverage within about two weeks.

Following that catch-up campaign, HPV has moved into the routine programme. From 2025 onward it targets a single yearly cohort: all girls aged 10 years, or those in grade (class) 6, are offered one single dose of 0.5 ml given intramuscularly in the left upper arm. In-school girls are vaccinated at their schools and out-of-school 10-year-olds at health facilities, typically during the month of Falgun (mid-February to mid-March). About 350,000 girls are eligible each year.

Nepal follows the World Health Organization and the country's National Immunization Advisory Committee (NIAC) recommendation that a single dose gives strong protection. The vaccine used is a bivalent HPV vaccine (against types 16 and 18), which cause the majority of cervical cancers. Cervical cancer is the leading cause of cancer deaths among Nepali women, so this addition is a major step toward the goal of eliminating the disease.

Every child in Nepal should receive an immunization card (khop card) at the first visit. The health worker records each dose and the date the next dose is due; bring this card to every visit and keep it safe, as schools and later health services may ask for it. If the card is lost, the health facility can usually reconstruct the record and continue the schedule.

Minor reactions such as mild fever, fussiness, or soreness and slight swelling at the injection site are common and settle within a day or two. These are signs the immune system is responding and are not a reason to delay future doses. Seek care promptly only for unusual reactions such as a high persistent fever, a large swelling, difficulty breathing, or a seizure.

All vaccines in this schedule are free at government health posts, primary health centres, district hospitals and outreach clinics. Some private hospitals offer additional optional vaccines (for example influenza, chickenpox, hepatitis A, or booster IPV at 18 months and 4-6 years) that are not part of the free national programme; parents may choose these on paediatric advice, but they are separate from the government khop schedule described here.