Vaccinations in Japan for Foreign Residents and Travelers: What Is Free, What You Pay For, and Where to Go

Two categories: routine and optional

Japan sorts vaccines into two legal categories. Routine vaccines (teiki sesshu) are listed under the Immunization Act and delivered by your municipality. For the diseases in Class A, which covers almost all childhood vaccines, everyone in the target age group is expected to be vaccinated, and the shot is free if you get it in the municipality where you are registered. Class B covers vaccines for older adults (seasonal influenza, COVID-19, pneumococcal disease and, since April 2025, shingles), for which the municipality may pay part of the cost. Everything else is an optional vaccine (nin'i sesshu): you decide, you pay the clinic's price, and the price varies from clinic to clinic. ^[1]

The practical consequence for foreign residents is simple. Once you register your address at the city or ward office, you are inside the system: the municipality mails questionnaires and coupons (yoshinhyo) for each routine vaccine as your child reaches the eligible age, and you take them to a contracted clinic. Outside the eligible age window, the same vaccine becomes optional and you pay for it out of pocket.

The routine schedule for children

The routine program starts at two months of age and runs through the teenage years. In outline it covers hepatitis B, rotavirus, the five-in-one combination (diphtheria, tetanus, pertussis, polio and Hib), pneumococcal disease, BCG for tuberculosis, measles and rubella (MR), varicella, Japanese encephalitis, a diphtheria-tetanus booster at age 11 to 12, and HPV for girls. Most of these are given in several doses spread over the first two years, with a second MR dose in the year before elementary school. The full schedule with age windows and intervals is published by the Japan Institute for Health Security and is updated each year, so do not rely on a chart that is more than a year old. ^[2]

Children arriving from abroad

A child who moves to Japan is entitled to every routine vaccine for which they are still within the age window, regardless of nationality. Bring the vaccination records from your home country, ideally with vaccine names and dates in English. A pediatrician (shonika) will map what has been given against the Japanese schedule, count the doses that match, and plan the rest. Vaccines that are routine in Japan but not at home, such as Japanese encephalitis or BCG, are the usual gaps. Ask the municipal health division for the questionnaires for your child's age; they are not always mailed automatically to families who register mid-year.

Vaccination records in Japan are kept in the Maternal and Child Health Handbook (boshi kenko techo), a small booklet that originated in Japan and records the pregnancy, the birth, the child's growth and every vaccination in one place. It is similar to the UK's red book or an Australian baby health record; the United States has no single equivalent, and records there are kept by the clinic and in state immunization registries. The municipality issues it to pregnant residents, and every clinic stamps it after a shot. Families who arrive with a young child can usually receive a handbook at the municipal office, and bilingual editions in several languages are available in many municipalities. Keep the handbook; you will need it for daycare, school and any future move.

Which vaccines do adults usually pay for?

For adults under 65, almost everything is optional. The seasonal influenza shot is the one most adults pay for. Clinics set their own price, and as a rough guide, one dose costs around ¥3,000 to ¥5,000, sometimes lower at large group practices and higher in central Tokyo. People aged 65 and over, and those aged 60 to 64 with severe heart, kidney, respiratory or HIV-related conditions, receive the influenza vaccine as a routine Class B vaccine each autumn, with the municipality covering part or all of the cost. Some municipalities also subsidize the shot for children or pregnant women on their own initiative. ^[4] See our influenza page for the season's timing.

Other adult vaccines, including hepatitis A and B, the pneumococcal vaccine for adults under 65, shingles outside the routine ages, MR boosters and tetanus boosters, are charged at the clinic's price. Two of these are routine Class B vaccines at certain ages, with the fee set by each municipality: shingles, for people turning 65 (and, as a transitional measure from fiscal 2025 to fiscal 2029, those turning 70, 75, 80, 85, 90, 95 or 100 in that fiscal year), and pneumococcal, for people aged 65. Some people aged 60 to 64 with severe underlying conditions also qualify. ^[7] Ask for a written estimate before you book, because the cost of a full course of a multi-dose vaccine can add up.

HPV vaccine: who gets it free

HPV vaccination is routine and free for girls from the sixth year of elementary school through the first year of high school, using the nine-valent vaccine. A catch-up program for women born between fiscal 1997 and fiscal 2007 who missed the routine window ran from April 2022 to March 2025; women born between fiscal 1997 and fiscal 2008 who had received at least one dose in that period could finish the remaining doses free until March 31, 2026; women who did not complete the course by then now pay for it as an optional vaccine. Boys are not covered by the national program, although a small number of municipalities subsidize the vaccine for them. ^[3]

COVID-19 vaccine: who can get it and what does it cost?

COVID-19 vaccination is now handled in the same way as influenza vaccination. It is a routine Class B vaccine given once a year in autumn and winter to people aged 65 and over and to those aged 60 to 64 with qualifying conditions, with a copayment set by each municipality and waived for low-income residents. Everyone else can still be vaccinated as an optional vaccine at full price. ^[5]

Travel vaccines for trips abroad

If you are traveling from Japan to a region with yellow fever, rabies, typhoid, hepatitis A or meningococcal risk, FORTH, the travel health website of the Ministry of Health, Labour and Welfare's quarantine stations, recommends starting as early as possible, ideally three months or more before departure, because several travel vaccines need two or three doses. Consult a travel clinic (toko gairai), often attached to a university or large hospital, for a schedule matched to your destination. Yellow fever vaccination and the international certificate are handled by quarantine stations and designated centers. All travel vaccines are optional, and you pay the full price. ^[6]

Where can you get vaccinated, and what should you bring?

Vaccines are given at clinics and hospitals, not at pharmacies: Japanese pharmacists do not administer injections, so a drugstore counter cannot help. Pediatric clinics handle the childhood schedule, internal-medicine clinics (naika) handle adult and influenza shots, and travel clinics handle vaccines for trips abroad. Most clinics require a reservation, and many order optional vaccines only after you book. Use our hospital search to find clinics with foreign-language support near you.

Bring your residence card, your My Number card or eligibility certificate (insurance does not cover vaccines, but the clinic uses it for identification), the municipal questionnaire and coupon for any routine vaccine, the Maternal and Child Health Handbook for children, and any overseas records. Expect a short interview about fever, allergies and past reactions before the injection, and a fifteen to thirty minute wait afterwards.

Side effects, reporting and the relief system

Mild fever, soreness and tiredness for a day or two are common. Doctors report suspected serious reactions to the national reporting system. If a routine vaccine causes lasting harm, the Immunization Act provides a relief scheme, the Vaccination Health Damage Relief System (yobo sesshu kenko higai kyusai seido), that pays medical costs, disability pensions and other benefits once a causal link is recognized. Claims go through your municipality. Optional vaccines fall under a separate scheme for medicines run by the PMDA. Ask the clinic which applies before you are vaccinated. ^[1]

Tourists and certificates

Short-term visitors are outside the municipal system and pay the full price for any vaccine; not every clinic stocks every product, so call ahead. If you need proof for travel, school or work, ask for an English certificate (eibun sesshu shomeisho): most clinics issue one for a fee within a few days, and the COVID-19 and yellow fever certificates have their own formats. Keep the original Japanese record as well, because any certificate issued later is checked against it.

Glossary

• 予防接種 (yobo sesshu) — vaccination
• 定期接種 (teiki sesshu) — routine vaccine under the Immunization Act
• 任意接種 (nin'i sesshu) — optional vaccine, paid out of pocket
• 予診票 (yoshinhyo) — pre-vaccination questionnaire and coupon
• 母子健康手帳 (boshi kenko techo) — Maternal and Child Health Handbook
• 接種済証 (sesshu zumisho) — vaccination record certificate
• 渡航外来 (toko gairai) — travel clinic
• 検疫所 (ken'eki-sho) — quarantine station
• 副反応 (fukuhanno) — side effect, adverse reaction