Your Baby's First Vaccines in the Pink Book: What, When, and Which Optional Ones Are Your Call

The first time you open the vaccine page of the pink book (สมุดสีชมพู, the Thai Mother and Child Health Handbook every family gets), your eyes glaze over. The page is full of abbreviations: BCG, HB, DTP-HB-Hib, IPV, OPV, Rota. Then at a private hospital there’s a whole extra list of “optional vaccines” to choose from, until you’re not sure which ones are required and which are a choice.

Let’s walk through which vaccines your baby gets free under Thai coverage from birth to 2 months, and which ones are decisions your family makes. But first: go by the appointment dates in the pink book and the advice of your baby’s doctor, because the schedule gets updated from time to time.

1. What vaccines has your baby already had at birth?

Quick Answer: Most babies get 2 at the hospital before going home: tuberculosis (BCG) and the first hepatitis B dose (HB1).

• BCG is injected into the skin, usually on the left upper arm or the hip. It protects young children against severe forms of tuberculosis.
• HB1 protects against the hepatitis B virus and is given at birth.
• If mom is a hepatitis B carrier, the doctor will give the baby extra care and schedule HB2 at 1 month as indicated. Some private hospitals schedule a 1-month dose as standard. Go by the appointment you were given.

Open the pink book now and check whether these 2 are recorded. If you’re not sure, write it down and ask the nurse at your first appointment.

2. The BCG spot has turned into a pus bump. Is that normal?

Quick Answer: Yes. About 2 to 3 weeks after the shot, a raised bump or small pus spot appears and comes and goes for several weeks, then heals on its own and leaves a small scar.

During this time:

• No medicine needed and no need to cover it. Clean it as usual at bath time.
• Never pick, squeeze or press the pus bump, even if older relatives say squeezing it out helps it heal faster.
• See a doctor if the bump is unusually large, pus keeps draining for a long time, or you can feel swollen lymph nodes in the armpit or groin.

3. What’s given at 2 months (current schedule)

Quick Answer: The 2-month visit is a big one. Your baby gets combined DTP-HB-Hib dose 1, injected polio vaccine (IPV) dose 1 and oral rotavirus dose 1, free under Thai coverage.

Age	Basic vaccines (free)	Protects against
Birth	BCG, HB1	Tuberculosis, hepatitis B
1 month	HB2 (only as indicated)	Hepatitis B
2 months	DTP-HB-Hib dose 1	Diphtheria, tetanus, pertussis (whooping cough), hepatitis B and Hib
2 months	IPV dose 1 (injected)	Polio
2 months	Rota dose 1 (oral drops)	Rotavirus diarrhea

The next round is the 4-month visit, with a similar set again. The combined vaccine protects against 5 diseases in one shot, so your baby doesn’t need several separate needles.

4. Why did my friend’s baby get polio drops at 2 months, but mine got a shot?

Quick Answer: Because since mid-2023 Thailand has switched polio to “2 shots, 3 drops”: IPV injections at 2 and 4 months, then OPV drops at 6 months, 18 months and 4 years.

Older siblings or relatives who had babies before then remember polio drops from 2 months, which was right for the old schedule. Some older pink books may still have the old schedule printed in them. Don’t worry that your baby has missed something. Follow what the hospital schedules and records in the book.

5. What to know about the rotavirus vaccine

Quick Answer: Rotavirus is an oral vaccine and is now free. There are 2 types: a 2-dose version (2 and 4 months) and a 3-dose version (2, 4 and 6 months). It has an age limit, so don’t postpone the appointment.

• CDC says the first rotavirus dose must be given before 15 weeks of age, and all doses must be finished before 8 months of age.
• After the drops, some babies are fussy or have mild, temporary loose stools or vomiting.
• A very rare side effect is intussusception (part of the intestine folding into itself), usually in the first week after dose 1 or 2. If your baby cries severely on and off while pulling their legs up to the tummy, vomits repeatedly, or has blood in their poop, go to the hospital right away.

6. Which optional vaccines do moms have to decide on?

Quick Answer: Around 2 months there are 2 main choices: an acellular pertussis or 6-in-1 combined vaccine instead of the basic one (you pay), and the pneumococcal vaccine (PCV), which is changing from paid to free.

Acellular pertussis (DTaP), or 5-in-1 and 6-in-1 combined vaccines The basic combined vaccine uses whole-cell pertussis. The acellular type has fewer side effects such as fever, pain and swelling, but you pay for it yourself at a private hospital or clinic. The 6-in-1 also includes IPV in the same shot. Both types protect well, so this comes down to each family’s budget and peace of mind. It doesn’t mean the free one is so inferior that you have to pay extra.

Pneumococcal vaccine (PCV, often called the IPD vaccine) It protects against bacteria that cause pneumonia, bloodstream infections and meningitis. It used to be paid only, but in 2026 NHSO (สปสช., Thailand’s National Health Security Office) added it as a benefit for Thai children, given in 3 doses at 2, 4 and 12 months. When the service actually starts may differ by area. At the 2-month visit, just ask the hospital, “Do you have free PCV here yet?” If not yet, or if you’d like a type that covers more strains, talk to the doctor about paying for it yourself.

If you choose optional vaccines, ask the nurse to record every one in the pink book, so they aren’t repeated if you change hospitals.

7. Caring for your baby after the shots, and when to call the doctor

Quick Answer: Fussiness, pain or swelling at the injection site, or a low fever in the first day or two can happen. But your baby is under 3 months old, so for any fever of 38°C or higher, always call the hospital.

Once you’re home:

• Feed as often as your baby wants, and hold and comfort them
• Dress them in light, comfortable clothes, no heavy blankets
• Don’t put compresses or anything on the injection site unless the doctor tells you to
• Don’t give fever medicine on your own if the doctor hasn’t told you the type and dose right for your baby’s weight. You can ask before you leave the hospital.

Go to the hospital right away if…

• Fever of 38°C or higher in a baby under 3 months (read more in Fever in babies under 3 months: why doctors say come straight in)
• Crying nonstop for hours that nothing soothes
• Drowsy, hard to wake, or not feeding
• Seizures, a floppy body, or a pale face
• Trouble breathing, swollen lips, or a rash all over the body after the shots
• Screaming on and off, pulling legs up to the tummy, repeated vomiting, or blood in the poop in the week after rotavirus drops

8. How much does mom’s immunity protect baby before the shots?

Quick Answer: It helps against some diseases. If mom had the pertussis (whooping cough) vaccine during pregnancy, the antibodies cross the placenta and protect the baby in the newborn period, but they don’t replace the baby’s own vaccines.

If you’re pregnant now or have a friend who is, read Pregnancy vaccines: which shots pass immunity to your newborn. At the 2-month visit, the doctor or nurse will usually weigh and measure your baby and ask about development too. Read First-month milestones: what to tell the doctor to get your questions ready, and for the big picture of the first 3 months, see A guide to your baby’s first 3 months.

On the day of those first shots, some moms cry right along with their baby. That’s completely normal. The pain lasts a moment, but the protection stays with them for a long time. Give your baby a big hug, and give yourself credit for keeping the appointment.