Regarding the optional recommendation for the 3-in-1 combination vaccine and polio vaccine

Before entering elementary school, it is recommended to get the 3-in-1 and polio vaccines, which are optional. As of March 2024 in Japan, the diphtheria, tetanus, pertussis, and polio vaccines are administered as a 4-in-1 vaccine (scheduled vaccination), with a total of four doses given by approximately 18 months of age. However, it has become known that immunity obtained from vaccines gradually decreases, and there is a possibility of contracting pertussis, etc., before entering elementary school.
In Japan as well, starting in August 2018, the Pediatric Society began recommending the fifth dose of the DTP (diphtheria, pertussis, tetanus) vaccine and the polio vaccine for preschool-aged children."Vaccine Information You Should Know" from the Japan Pediatric Society [External Link](As of March 2024, both are voluntary vaccinations). "5-dose vaccination" is also recommended by the WHO, and some countries administer an additional dose in adolescence or adulthood (WHO Immunization Data portal - External link）
Regarding whooping cough, according to infection reports from 2018 and 2019, over 60% of infected individuals were elementary and junior high school students.Epidemiology of Pertussis Cases Reported in the Country Based on Routine Reporting Surveillance (Update) External linkAlso, about 80% of infected individuals had received four doses of the DTaP or DTaP-IPV vaccine during childhood. This means that immunity decreases within a few years even after receiving the DTaP or DTaP-IPV vaccine as part of the regular vaccination schedule.
🔸Regarding polio, antibody titers gradually decrease over time after vaccination, exposing individuals to the risk of developing the disease.Want to know more about polio (vaccine-net.jp) external link
Regarding the vaccine to be used for the fifth dose, combining the DTaP vaccine and the standalone polio vaccine is effectively the same as a DTaP-IPV combination vaccine. However, as of March 2024, the DTaP-IPV combination vaccine can only be used for the four routine vaccinations. Therefore, for the fifth dose, the DTaP vaccine (Trivirix®) and the polio vaccine (Imovax®) will be administered separately as optional vaccinations.

What is polio?　

Overview of Polio (Acute Poliomyelitis)(5-in-1 vaccine) Ministry of Health, Labour and Welfare (mhlw.go.jp)
🔵 It was once called "polio" and there were major outbreaks in Japan. Until vaccines were introduced, there were thousands of cases and deaths every year.
🔸Even if infected with the poliovirus, in most cases, there are no noticeable symptoms. In very rare cases, paralysis (inability to move limbs or difficulty breathing) can occur, leading to lifelong disability. There is no specific treatment. This is a preventable disease through vaccination.
Polio has been eradicated domestically, but new cases still occur in some parts of the world. Because there is a possibility of polio virus being brought into the country from those regions, it is necessary to maintain high immunity through vaccination.

😰What is whooping cough?

A sudden, violent cough, followed by a wheezing sound, is characteristic. In infants under 3 months old, it can lead to suffocation and, in severe cases, death.Not an infectious disease with lifelong immunity (once infected, you won't get it again).Therefore, it is possible to contract whooping cough multiple times, similar to a cold. In Japan, thousands of patients are reported annually from approximately 3,000 pediatric institutions.About Pertussis (Whooping Cough) - Vaccine4All.jp (External Link)For more details, please visit the society's website.Recommended Vaccination Schedule by the Japan Pediatric Society, Standard Vaccination Period / Japan Pediatric Society's Way of Thinking / Precautions (External Link)Please refer to

Regarding the start of the 5-in-1 (Diphtheria, Pertussis, Tetanus, Inactivated Polio, Hib) vaccination.

🔵 Starting April 1, 2024 (Reiwa 6), the 5-in-1 vaccine (diphtheria, pertussis, tetanus, inactivated polio, and Hib) has been introduced as a routine vaccination.

Regarding 15-valent pneumococcal conjugate vaccine (Vaxneuvance®)

🔵 Starting April 1, 2024, our clinic will be using the 15-valent pneumococcal vaccine (Vaxneuvance®) for routine vaccinations, replacing the previous 13-valent vaccine.
🔸Supplement: In June 2023, the pediatric indication for the 15-valent pneumococcal conjugate vaccine (Vaxneuvance®) was approved. The added indication is "Prevention of invasive diseases caused by *Streptococcus pneumoniae* serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F in pediatric individuals."
Pneumococcus is a Gram-positive coccus classified into over 90 serotypes based on its antigenicity, and it is one of the major respiratory pathogens. When this bacterium invades cerebrospinal fluid or blood, it causes invasive pneumococcal infections such as sepsis and meningitis.
In our country, the 13-valent pneumococcal conjugate vaccine (PCV13 Prevenar 13®) has been used for routine pediatric vaccination since November 2023. Despite the implementation of routine pediatric vaccination with PCV13, the incidence rate of invasive pneumococcal disease in children has not decreased, which remains a significant public health issue. Overseas, it has been reported that serotypes 22F and 33F are major causes of invasive pneumococcal disease in children under 5 years of age.
🔸Bexsero® is a 15-valent pneumococcal conjugate vaccine (PCV15) that is effective against two additional serotypes (22F and 33F) in addition to the serotypes included in PCV13. If you switch to PCV15 during the vaccination schedule after starting with PCV13, the remaining doses will be given with PCV15.

Vaccinations for studying abroad or traveling overseas

There are two main aspects to vaccinations for overseas travelers. The first is for countries (regions) that require vaccinations upon entry. The second is to protect your body from infectious diseases abroad.
Some types of vaccinations require multiple doses (2-3 doses).
If you plan to travel abroad, please consult about the types of vaccines to receive and the vaccination schedule as soon as possible (preferably at least 3 months before departure).
Vaccinations for overseas travel - Ministry of Health, Labour and Welfare Quarantine Station - External link