Egypt MOH Childhood Vaccination Schedule 2026: Complete Guide for Pediatricians

The 2026 Egyptian EPI schedule

The Egyptian Ministry of Health Expanded Programme on Immunization (EPI) provides free vaccines to all Egyptian children through government health units. The 2026 schedule includes significant updates from 2023, including the addition of the rotavirus vaccine to the national programme and revised meningococcal recommendations.

The following schedule applies to all children born on or after 1 January 2024.

Birth to 2 months

At birth

• BCG (Bacillus Calmette-Guérin): Single intradermal dose, left deltoid. Given before hospital discharge. Protects against severe tuberculosis in children.
• Hepatitis B (HepB-1): First dose, given within 24 hours of birth. Intramuscular, anterolateral thigh in newborns.
• OPV-0 (Oral Polio Vaccine): Zero dose, 2 drops oral. Given at birth for additional mucosal immunity.

At 2 months

• OPV-1: 2 drops oral
• IPV-1 (Inactivated Polio Vaccine): 0.5 mL intramuscular, anterolateral thigh
• Penta-1 (DTP-HepB-Hib): Pentavalent vaccine combining diphtheria-tetanus-pertussis, hepatitis B (dose 2), and Haemophilus influenzae type b. 0.5 mL intramuscular.
• PCV13-1 (Pneumococcal): First dose. 0.5 mL intramuscular, contralateral thigh from Penta.
• Rota-1 (Rotavirus): First dose, 1.5 mL oral. NEW in 2024 national schedule.

4 months

• OPV-2
• IPV-2
• Penta-2
• PCV13-2
• Rota-2

6 months

• OPV-3
• Penta-3 (= HepB-3): Completes the primary hepatitis B series
• PCV13-3

9 months

• MMR-1 (Measles-Mumps-Rubella): 0.5 mL subcutaneous injection, right upper arm
• MenA (Meningococcal A): Single dose, 0.5 mL intramuscular. Added to national schedule for children in high-transmission governorates.

12 months

• PCV13 booster: Fourth dose completes the pneumococcal series
• Varicella-1: Added to the national schedule in 2024 for children not previously vaccinated

18 months

• OPV booster
• Penta booster (DTP-Hib booster)
• MMR-2: Second MMR dose for full immunity. Given as a combined MMRV if Varicella-2 is co-administered.
• Varicella-2

4–6 years (school entry)

• OPV
• DT (Diphtheria-Tetanus): School-entry booster

11–12 years

• Td (Tetanus-diphtheria): Adolescent booster
• HPV: Not yet in the national programme but recommended by the Egyptian Society of Pediatrics for girls at 11–12 years (2 doses, 6–12 months apart)

Catch-up vaccination principles

Children presenting late for vaccination should not restart the series from the beginning — they should continue from where they left off, respecting minimum intervals:

• Minimum interval between OPV/IPV doses: 4 weeks
• Minimum interval between Penta doses: 4 weeks
• MMR first dose: Can be given any time after 6 months; if given at 6–11 months, repeat at 12 months
• PCV catch-up: Doses depend on age at first presentation — a condensed schedule applies for children presenting after 12 months

Cold-chain requirements

All MOH EPI vaccines must be stored between +2°C and +8°C at all times. Key cold-chain rules:

• Freeze-sensitive vaccines (DTwP, DT, Td, HepB, Hib, PCV, IPV) must never be frozen — freezing permanently destroys potency
• Freeze-tolerant vaccines (OPV) can be stored frozen but must be used within 30 minutes once thawed
• BCG must be stored in the dark — light exposure degrades potency
• All vaccines should be stored in the inner shelves of the refrigerator, away from the freezer compartment and away from the door

VVM (Vaccine Vial Monitor): Check the VVM square on each vaccine before administration. If the inner square is darker than or equal in colour to the outer circle, do not use the vaccine — return it to the cold chain supervisor.

Documentation requirements

For each vaccination administered, the following must be recorded:

• Vaccine name and type
• Batch/lot number
• Expiry date
• Date and time of administration
• Route and site
• Administering health professional
• Adverse events, if any

The MOH Child Health Record booklet (the yellow vaccination card) must be updated at each visit and given to the guardian to keep. Clinit generates a printable vaccination summary in the MOH format from the digital record.

Managing vaccine hesitancy

Vaccine hesitancy is increasing in Egypt, driven primarily by misinformation on social media about MMR and autism (a claim that has been completely and repeatedly refuted by large-scale epidemiological evidence across hundreds of millions of children). When encountering hesitant parents:

• Listen without interrupting — understand their specific concern
• Acknowledge the concern as understandable
• Provide clear, accurate information — "The largest study ever done on this question followed 650,000 children and found no link between MMR and autism"
• Do not argue or be dismissive — it increases resistance
• Offer to defer the vaccination until a follow-up appointment if the parent needs time to consider — the vast majority will proceed