All about baby vaccination card

When my husband and I were expecting our first child, the nurses and midwives asked me about when I’d received normal childhood vaccinations are part of routine pre-natal testing. When I brought up the subject with my husband, there wasn’t a single disagreement: we would vaccinate our children when recommended by health professionals, and we were willing to pay out-of-pocket for (the very, very few) shots that were not covered by the healthcare system.

In general, Spaniards are in favor of routine vaccinations at any age.

Records are kept via a baby vaccination card that is usually digital and in hard copy form for your records; this is true of the public system, and my experience in having children insured via my husband’s private insurance is that the regional health system does the same to be sure that all school-aged children have their records verified and recorded in a public database.

What is the baby vaccination card, or cartilla de vacunación, in Spain?

The baby vaccination card, known as a cartilla de vacunación, is a record off all inoculations before the age of 12. Typically, it is administered to a family at birth or during a first check-up but could also be given at the time of a first jab, usually around two months.

As healthcare is managed at the regional level, and because there are slight differences between autonomous regions, the card might look different. In the case of my older child, who received all his mandatory vaccines prior to age 3 in Madrid, the baby vaccination card for the Comunidad de Madrid came in the middle of a booklet of childhood health where pediatricians could write in observations from well-child appointments. In the case of my younger child in Andalucía, his booklet contains only the names of the vaccination and a place to write or stick the serial number of the doses and the date.

Like in other developed countries, many shots contain multiple vaccinations all at once, such as the MMR (measles, mumps and rubeola). So, less “pinchazos” but the same efficiency.

Is the vaccination calendar the same throughout Spain?

Public healthcare covers nearly every routine vaccination for children, though each autonomous region’s vaccination card may look a bit different. There could also be a slight variation in when children receive each jab.

In our case, our children have private insurance through my husband’s company. We received a vaccination booklet shortly after their birth with the local calendar listed in both cases, even though the booklets look different and one of the shots was administered at 11 months as opposed to 12, as per national recommendations.

Are vaccinations free in Spain?

The Spanish government has a list of vaccines and timing of administrated doses that serves as the basis for all regions and territories of the country. Despite slight regional differences, children will get the following shots covered as residents in Spain:

• Polio (poliomielitis) at 2, 4, 11 months and a booster at 6 years.
• Dyptheria, tetanus, whooping cough (difteria, tétanos, tosferina) at 2, 4, 11 months and a booster at 6 years; pregnant women also receive this in weeks 27-30 of their gestational period.
• Haemophilus influenzae b, a bacterial disease, at birth in addition to 2, 4 and 11 months.
• Hepatitis B, at birth in addition to 2, 4 and 11 months. Note that vaccination timing can depend on whether or not the baby and/or its mother is AgHBs positive.
• Measles, mumps and rubeola (sarampión, paradotis, rubeola) at 12 months, with a booster between 3-4 years of age.
• Chicken pox (varicela) at 15 months, with a booster between 3-4 years.
• HPV (virus del papiloma humano) at 12 years for females only. Consult with your pediatrician about ages and the type of vaccine administered, as the separation between doses and the age of the patient can greatly vary, or catch ups may need to be administered.
• Pneumococcal disease (enfermedad neumocócia) at typically 2, 4 and 11 months, then recommended yearly from 65 years of age. Consult with a doctor, as this is a relatively new addition to the vaccinator card and calendar.
  
  

Additionally, pregnant women are encouraged to get a flu vaccine if they are pregnant in the fall and/or winter, where a bad flu can cause problems in a pregnancy; you can read more about high-risk pregnancies here.

If you are using private healthcare, check with your provider about whether or not you must pay to vaccinate your children. In many cases, your healthcare company will cover these shots, and you will not be asked to pay out-of-pocket with reimbursement. Remember that some shots, such as the meningitis B vaccine at two months, is not currently covered in most autonomous regions for children born in 2019 or before. Families who wish to vaccinate their child against HPV must also pay.

For additional information in English about vaccination in adults, prematurely born babies or children, please visit the Ministry of Health. The European Centre for Disease Prevention and Control also provides a handy tool to see at what age certain vaccinations are recommended.

What’s new for 2025 for children’s vaccinations in Spain?

One of the biggest changes to childhood vaccination schedules in all of Spain is that the flu shot is recommended yearly for children between 5 and 18. This is an optional shot will be at a family’s cost.

Other vaccines are strongly suggested by are not yet national, such as the SARS-CoV-2 vaccine for certain risk groups or a booster for meningococcal A, C, W and Y. Again, this shot will be out-of-pocket. The Comité Asesor de Vacunas e Inmunizaciones (in Spanish) is your best source of information.

Further, the Td shot has now been replaced with the Tdpa for anyone 10 and older in nearly every region of Spain.

What vaccinations will I have to pay for in Spain for my child?

As previously stated, most vaccines are covered by your local government via spending in public healthcare. One that many parents opt to pay for is the rotavirus vaccine, which should be first administered via oral ingestion at 6-7 weeks, followed by a booster at 2-6 months.

We opted to pay for the rotavirus vaccine, two different shots against different types of meningitis and various doses of each. I would estimate the cost, per child, to be about 400€ in total, for children born in 2017 and 2019.

If you have private insurance, like any of Caser’s comprehensive insurance plans for families, check your policy. Caser’s policies will reimburse you for 50% of vaccinations for 50% of routine jabs (up to 100€ per insured person annually).

Reminder: If you have any of Caser’s health insurance plans for expats, you can take advantage of telehealth appointments – often without a co-pay and in a range of specialties – to not only get a medical opinion but also ask for a prescription or referrals for medical tests so that you’re on the mend as soon as possible. It’s as simple as downloading the app and scheduling an appointment, then downloading your scrip in the app. Finally, file for reimbursement.

Don’t have Caser insurance especially designed for expats? Explore plans by starting with the cost calculator, filling in relevant data for your entire family and choosing the coverage options that best meet your family’s needs. You’ll have access to hundreds of Spain’s best professionals and care centers and a number of additional perks, from Telehealth to choosing your preferred professional and skipping long waiting lists.

Where can babies and children get vaccinated in Spain?

If your center does not do inoculations, you can usually get a prescription to purchase the shots in the pharmacy, then take them to a centro de salud and have a nurse administer and record the doses. Hospitals will usually do them, too (my son gets vaccinated at the hospital next door once a month – we simply bring in his vaccine vials and wait our turn). Inquire with your pediatrician about how and where to procure an appointment for inoculations.

The takeaway

While vaccines and mandatory inoculations are a hot topic in the adult world, nearly every parent in Spain opts to fully vaccinate their children, especially when they are of school age. In a fragile time in a child’s health and more susceptibility before the age of 5, we were more concerned about sniffles and upset tummies than a potentially life-threatening disease. Expats and residents alike can take advantage of having their children receive vaccinations for free or a low cost and ultimately save peace of mind when the efficiency of vaccines has been tested in youngsters.