Japan's Five-in-One Vaccine (DTaP-IPV-Hib): The Complete Guide

What Is the Five-in-One Vaccine?

The five-in-one vaccine — called 五種混合ワクチン (goshukongo wakuchin) in Japanese — is a single injection that protects against five serious diseases at once. It became part of Japan's routine (free) vaccination schedule on April 1, 2024.

Before that date, parents had to book separate appointments for a four-in-one vaccine and a Hib vaccine, which meant more clinic visits, more injections, and more scheduling headaches. The five-in-one combines them into a single shot.

The Five Diseases It Covers

Of these five, pertussis and Hib disease are the ones parents most need to know about. Both are particularly dangerous in the first few months of life — before your baby has had time to build up any immunity. Getting the first dose in at two months is the best protection you can give.

Why Japan Introduced It

Until March 2024, Japanese parents had to vaccinate against these five diseases using two separate injections: a four-in-one vaccine (四種混合, yonshukongo) covering diphtheria, pertussis, tetanus, and polio, plus a standalone Hib vaccine. That meant up to eight separate injections over the first year and a half of a child's life.

The five-in-one vaccine cuts that down to four injections total. For babies who are already getting multiple vaccines at each visit — which is standard — reducing the number of individual shots matters, even if the total number of clinic visits stays roughly the same.

The four-in-one vaccine ceased production during 2024, and Japan's national stock was completely exhausted by July 2025. Any child who could not complete their series with the old vaccine would continue with the five-in-one instead.

Vaccination Schedule

The five-in-one is given in four doses total — three doses for the primary series, then one booster.

The eligible age range runs from 2 months up to 7 years and 6 months (90 months). If you're late starting for any reason, your paediatrician can adjust the schedule — the important thing is to get going.

Is It Free?

Yes — the five-in-one vaccine is a 定期接種 (teiki sesshu), meaning it's part of Japan's national routine vaccination programme. All doses are fully covered by your municipality at no cost.

Eligibility is based on 住民登録 (juuminhyou registration), not nationality. If your child is registered at your local city or ward office, they are entitled to the same free routine vaccines as any Japanese child. Your municipality will send vaccination vouchers (接種券, sesshuken) by post.

If you haven't received anything by the time your baby is approaching 2 months old, contact your local health centre (保健センター, hoken sentaa) to ask.

What Happens at the Appointment

The five-in-one is given as an injection — either subcutaneous or intramuscular, at the doctor's discretion. For babies under one year, the outer thigh is the standard injection site. It's over in seconds — most of the appointment time is spent on the pre-vaccination questionnaire (予診票, yoshinhyou) and a brief check by the doctor.

Expect multiple vaccines at the same visit. At the 2-month appointment — which is typically the busiest — it is standard practice in Japan to give four vaccines simultaneously:

• Five-in-one (五種混合)
• Hepatitis B (B型肝炎)
• Rotavirus (oral drops, not an injection)
• Pneumococcal (小児用肺炎球菌)

Simultaneous vaccination is completely standard practice in Japan and is backed by the same safety evidence as elsewhere in the world. The vaccines can be given at the same visit because the five-in-one is an inactivated vaccine — there's no interval restriction between inactivated vaccines.

Side Effects

Local reactions at the injection site are very common — about 75–79% of babies will have some redness, and around half will develop a firm lump (硬結, kouketsu). These are normal immune responses and typically clear up within a few days.

The hard lump can take a few weeks to go away completely — this is normal and nothing to squeeze or massage. If your baby has a high fever above 39°C, is unusually difficult to settle, or if the redness is spreading significantly, contact your clinic.

What If My Child Started the Old Vaccines?

If your child received some doses of the four-in-one (四種混合) and Hib vaccines before the five-in-one was introduced, switching to the five-in-one mid-series is officially permitted. This is confirmed in MHLW guidance issued to municipalities across Japan.

Since the four-in-one vaccine ceased production in 2024 and Japan's national stock ran out completely by July 2025, completing the old series is no longer an option for most families.

How many additional doses are needed depends on exactly how many doses of each old vaccine your child already received — this varies from child to child. Contact your paediatrician and bring your child's 母子手帳. They will review the vaccination history and advise on what is still needed. Your local municipality's health centre (保健センター) can also help clarify the process.

What to Bring

• 母子手帳 (boshi techou) — your Mother and Child Health Handbook. The clinic records every vaccination in here.
• 接種券 (sesshuken) — the vaccination voucher sent by your municipality. Without this, you may be charged.
• 予診票 (yoshinhyou) — the pre-vaccination health questionnaire. Some municipalities send this with the voucher; others provide it at the clinic.
• マイナ保険証 — your My Number health insurance card. If you don't have one, bring your 資格確認書 (shikaku kakunin-sho), the alternative certificate issued by your insurer. The old health insurance card (健康保険証) was abolished in December 2024.
• A spare set of clothes for your baby — just in case.

Working out where the five-in-one sits alongside the other routine shots is easier with the whole calendar in front of you — our complete guide to Japan's childhood vaccination schedule lays out the order and the ages.

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