Childhood vaccination in Morocco 2026: official schedule, BCG, DTaP, HPV — complete guide

01Official childhood vaccination schedule in Morocco — 2026#

The National Immunisation Programme (PNI), coordinated by the Moroccan Ministry of Health and Social Protection, has been the backbone of paediatric public health in the country since 1987. In 2026, its schedule covers eleven preventable diseases during the first two years of a child's life, with national vaccination coverage exceeding 95 % for infant antigens according to the latest joint WHO / UNICEF JRF reports. This achievement, among the highest on the African continent and in the Arab world, results from a network of more than 2,800 urban and rural health centres, a policy of strict gratuity in the public sector, and the systematic integration of the child health booklet into the school registration process.

The 2026 official schedule provides for a first injection at birth (BCG and first dose of hepatitis B), followed by a series of appointments at 2, 3, 4, 9, 12 and 18 months. Pre-school and primary-school boosters are then added, together with a dT-Polio dose during adolescence. The Moroccan PNI is progressively aligning with World Health Organization recommendations and adopts new antigens as they are validated by the national committee of vaccinology experts and the national technical advisory commission on immunisation.

Alongside the official, free PNI schedule, several vaccines recommended but not included in the national programme are available only in the private sector against payment. This is the case for the human papillomavirus (HPV) vaccine, the ACWY or B meningococcal vaccines, the rotavirus vaccine, the varicella vaccine and the hepatitis A vaccine. These vaccines represent a parental investment of between 200 and 3,500 dirhams per dose depending on the brand, and reimbursement by AMO (Compulsory Health Insurance) managed by ANAM remains partial and variable across funds (CNSS for private-sector employees, CNOPS for civil servants).

Understanding the chronological logic of this schedule, distinguishing mandatory PNI vaccines from additional recommendations, and knowing where to vaccinate one's child — public health centre, private paediatric practice, private clinic — has become a major concern for Moroccan parents and for Moroccans abroad (MRE) returning temporarily to the country. This article provides an exhaustive 2026 update on the official schedule, recommended vaccines, real prices, AMO coverage, catch-up immunisation and management of side effects.

02BCG at birth: tuberculosis and a Moroccan specificity#

The BCG (Bacillus Calmette-Guérin) vaccine is administered within 24 to 48 hours after birth, ideally before discharge from maternity. Morocco, classified by WHO among countries with intermediate tuberculosis incidence (around 99 cases per 100,000 inhabitants in 2024 per the global WHO report), maintains universal BCG vaccination of all newborns, unlike France or the United Kingdom which abandoned generalised vaccination in favour of a risk-targeted strategy. This difference is fundamental and explains why a child born in France to Moroccan parents and vaccinated according to the French schedule will not be considered up to date for school enrolment in Morocco, and vice versa.

The injection is given by strict intradermal route on the postero-external aspect of the left arm. The technique requires specific training because an accidental subcutaneous injection can cause a deep abscess or suppurative lymphadenitis. The injection wheal disappears within minutes and typically evolves into a red nodule at week 3, which ulcerates, oozes for several weeks and heals leaving a characteristic round scar — this evolution is normal and requires no local treatment other than a dry compress in case of heavy oozing. Moroccan parents, sometimes worried by the scar which may take 4 to 6 months to stabilise, must be reassured that it is the witness of an effective immune response.

BCG effectively protects against severe disseminated forms of tuberculosis in the infant — tuberculous meningitis and miliary disease — with efficacy estimated at 70-80 % for these forms according to BCG REVAC meta-analyses. Serious complications are rare but exist: disseminated BCG disease in children with previously undiagnosed severe combined immunodeficiency (which is why BCG vaccination is contraindicated where there is a family history of immune deficiency), suppurative axillary adenitis sometimes requiring surgical drainage, keloid scarring. Any worrying sign — hot abscess, large fluctuant lymph node, persistent fever — warrants prompt paediatric consultation. For families whose newborn could not receive BCG in maternity, vaccination can be caught up at the health centre up to age 5, but a tuberculin intradermal test (IDR) is required after 3 months of age to rule out latent infection.

03Pentavalent DTaP-Hib-HepB: the cornerstone#

From 2 full months, the Moroccan infant receives the first injection of pentavalent vaccine, containing diphtheria, tetanus, whole-cell pertussis (DTwP), Haemophilus influenzae type b (Hib) and hepatitis B antigens. The vaccine used in the Moroccan PNI is mainly Pentavac or Quinvaxem depending on UNICEF supply, with a formulation that combines what once required three to five separate injections in a single intramuscular shot. The vaccination schedule comprises three doses at 2, 3 and 4 months, then a first booster at 18 months with DTaP-Polio.

Each of these five valences targets a disease historically responsible for considerable infant mortality. Diphtheria, which manifests as suffocating pharyngeal pseudomembranes and sometimes lethal cardiotoxicity, has been almost eradicated thanks to mass vaccination — fewer than five cases reported per year since 2010. Neonatal tetanus, caused by umbilical-cord contamination in babies born to unvaccinated mothers, was eliminated as a public health problem in 2012, a joint achievement of the PNI and the antenatal tetanus immunisation programme. Pertussis nonetheless remains endemic with epidemic cycles every 3 to 5 years, and continues to cause death in infants under 6 months who are insufficiently vaccinated. Haemophilus influenzae type b was, before the introduction of Hib in the PNI in 2008, the leading cause of bacterial meningitis in Moroccan infants, with a case-fatality rate of 5 to 10 % and neurological sequelae — deafness, epilepsy, learning disability — in roughly a third of survivors; its near disappearance is one of the finest public health victories of the 2010s. Hepatitis B, whose chronic prevalence remains estimated at 1.8 % of the general population according to HCP and Ministry of Health surveys, has now essentially disappeared among children vaccinated with a complete series.

Pentavalent tolerance is broadly good, but parents should be prepared to observe a local reaction at the injection site (redness, induration, tenderness lasting 24-48 hours), a moderate fever of 38 to 39 °C within 24 hours in about 30 % of children, and more rarely irritability with persistent crying or unusual drowsiness. These manifestations are expected and do not contraindicate continuing the schedule. Paracetamol in paediatric suspension at 60 mg/kg/day in four divided doses may be administered preventively or on demand. Fever above 40 °C, febrile seizures, hypotonic-hyporesponsive episodes or crying persisting beyond three hours must be reported to the paediatrician.

04IPV: ongoing global eradication of polio#

Poliomyelitis is one of the last great WHO eradication projects. Morocco, whose last polio epidemic dates from 1989, has been officially certified polio-free since 2002. To maintain this status, the PNI switched in 2016 from the trivalent oral polio vaccine (OPV) to the inactivated polio vaccine by injection (IPV) alone, in line with SAGE recommendations.

The Moroccan IPV schedule today provides for three doses at 2, 3 and 4 months given together with the pentavalent (distinct vaccine but single consultation), then a booster at 18 months integrated with DTaP-Polio, and finally a booster at 6 years at primary-school entry. For children travelling to countries where wild poliovirus still circulates — chiefly Afghanistan and Pakistan — or to territories flagged by WHO for circulating vaccine-derived poliovirus (cVDPV2), the paediatrician may propose an additional booster dose in line with the International Health Regulations. Moroccans living abroad (MRE) returning for holidays with children vaccinated in Europe must ensure they bring the international vaccination booklet so that the Moroccan schedule can be reconciled consistently.

05MMR: measles, mumps, rubella#

The MMR (Measles-Mumps-Rubella) vaccine is one of the most important in the schedule due to the potential severity of measles — encephalitis, subacute sclerosing panencephalitis, severe pulmonary superinfections — and the risk of congenital rubella in unimmunised pregnant women. The Moroccan PNI has administered a first dose at 9 months since 2010, followed by a second dose at 18 months since 2014. This two-dose strategy at early ages enables effective immune coverage from walking age, a period of increased exposure to collective contacts.

Morocco has signed up to the WHO-AFRO Regional Plan for Measles and Rubella Elimination, with an elimination target originally set for 2020 and subsequently deferred because of the impact of the COVID-19 pandemic on routine vaccination coverage. Localised measles outbreaks continue to flare periodically, including in the Béni Mellal, Marrakech and Tangier regions in 2024-2025, reflecting pockets of insufficiently vaccinated children. Any febrile rash accompanied by conjunctivitis, rhinitis and cough in a pre-school-age child should raise the suspicion of measles and prompt notification to the regional health authorities to limit further spread.

MMR tolerance is broadly good but has two particularities worth knowing. First, a late fever between days 5 and 12 post-injection is common and corresponds to the replication phase of the attenuated vaccine virus — it is neither measles nor a transmissible disease. Second, a discreet maculopapular rash may accompany the fever. Neither warrants alarm or constitutes a contraindication to the second dose. MMR is, on the other hand, contraindicated in children with severe immune deficiency, in those undergoing chemotherapy or high-dose corticosteroid therapy, and in pregnant women (for which reason pregnancy should be avoided during the month following vaccination in adolescent or young-adult catch-up). The false belief of a link between MMR and autism, stemming from a fraudulent study published by Andrew Wakefield in 1998 in The Lancet and retracted by the journal in 2010, has been refuted by more than twenty large-scale epidemiological studies, including the Danish cohort of 657,461 children published in the Annals of Internal Medicine in 2019. Moroccan paediatricians should bear in mind that this misinformation still circulates on social media and requires a patient, evidence-led response at every consultation.

06Recommended vaccines not included in the PNI: HPV, meningococcal, rotavirus, varicella, hepatitis A#

Beyond the free official schedule, several vaccines recommended by learned societies are available in the private sector. Their prescription is a family discussion taking into account epidemiological context, budget and insurance cover. All can be ordered at the pharmacy on paediatric prescription; for some, periodic supply shortages make it useful to consult a local pharmacy listing or to ask a private paediatrician equipped with vaccine refrigerators.

The human papillomavirus (HPV) vaccine is the most emblematic of these additions. Its priority target is the prevention of cervical cancer, the leading cause of cancer death in Moroccan women aged 30 to 50 according to the Greater Casablanca and Rabat oncology registries. Morocco announced in 2023 the progressive integration of HPV vaccination into the PNI for girls aged 11, with effective deployment in pilot regions in 2024-2025. Pending nationwide rollout, HPV vaccination is available in private paediatric practice with two main brands — Gardasil 9 (nonavalent, covering nine oncogenic and condylomatous serotypes) and Cervarix (bivalent 16/18) — at 800 to 1,100 dirhams per dose, i.e. 1,600 to 2,200 dirhams for the two-dose schedule in pre-adolescents or 2,400 to 3,300 dirhams for the three-dose schedule in older adolescents. HPV vaccination is also beneficial in boys, recommended by the French HAS since 2019 and by North American learned societies to prevent oropharyngeal and anal cancers.

The quadrivalent conjugate meningococcal ACWY vaccine (Nimenrix, Menveo) or meningococcal B vaccine (Bexsero) targets meningitis and septicaemia. Bexsero costs around 1,200 dirhams per dose, Nimenrix 800 dirhams. Meningococcal vaccination is particularly recommended before travel to endemic areas (African meningitis belt, pilgrimage to Mecca where the ACWY vaccine is compulsory with an international certificate for the Hajj or Umrah visa).

Rotavirus is responsible for severe acute gastroenteritis in infants, with a risk of dehydration and hospital admission peaking during the winter season. Rotarix (monovalent oral) or RotaTeq (pentavalent oral) is given between 6 weeks and 6 months depending on the brand, two to three doses at 400 to 700 dirhams per dose. The varicella vaccine (Varilrix, Varivax) at two doses costs 600 to 800 dirhams per dose; it is recommended in children who have not had natural chickenpox and particularly before entry into collective care. The hepatitis A vaccine (Havrix, Avaxim paediatric) in two doses 6-12 months apart, at 250 to 400 dirhams per dose, is advised from age 1 and strongly recommended before travel to endemic zones or for MRE returning regularly to Morocco with children born in Europe.

AMO coverage of these recommended vaccines varies. CNSS and CNOPS partially reimburse certain vaccines prescribed on paediatric ordonnance at the ANAM reference rate; the effective remainder for the family is generally 60 to 80 % of the purchase price. Private supplementary insurances (Saham, Wafa, AXA Maroc, Atlanta) cover more depending on contracts. Always keep the pharmacy invoice and paediatrician care voucher for reimbursement. For complex reimbursement questions, a paediatric consultation with a contracted practitioner makes building a coverage file easier.

07Health booklet and certificates#

The child health booklet, issued free of charge at birth in all Moroccan public maternities and by contracted private paediatricians, is the reference document where all vaccinations are recorded. It contains pages dedicated to the official PNI schedule with space for vaccine batch labels, administration date, vaccinator signature and centre stamp. Its presentation is required for nursery registration, entry into kindergarten and primary school, and during any hospital admission. Loss of the booklet requires a duplicate request to the issuing health centre or, failing that, reconstruction from the vaccination records held in the National Health Information System (SNIS).

For MRE or children vaccinated abroad, schedule equivalence is managed case by case by the paediatrician or school doctor. Vaccines administered in Europe or North America with documented proof (European booklet, WHO yellow booklet) are recognised, but BCG must be added if it was not given at birth, unless the child is older than 5 (post-school-age BCG is no longer systematic). The international vaccination certificate (WHO yellow booklet) remains mandatory for certain international travel, notably yellow fever before a trip to sub-Saharan Africa and meningococcal ACWY before the pilgrimage to Mecca.

08Where to vaccinate your child#

Three main options coexist for paediatric vaccination in 2026. The public health centres of the Ministry of Health, distributed in every municipality, offer total gratuity of the official schedule with no prior registration requirement. Quality of vaccine storage conditions is guaranteed by the national cold chain. The main drawback concerns morning queues, sometimes long in dense urban areas, and limited opening hours (generally 8 am-12 pm and 2-4 pm on weekdays, closed at weekends).

Private paediatric practices offer a paid but often more comfortable alternative. The fee for a paediatric consultation including the vaccine procedure varies from 200 to 500 dirhams depending on city and practitioner reputation — Casablanca, Rabat, Marrakech and Tangier post the highest fees, particularly in residential districts such as Anfa, Souissi and Hivernage. The private paediatrician can administer PNI vaccines on the basis of doses supplied by the neighbourhood health centre (the parent collects the free dose and transports it under cold-chain conditions in an insulated vaccine carrier issued by the centre), or administer privately purchased vaccines for non-PNI recommendations. The consultation includes a full clinical examination, monitoring of staturo-ponderal growth, a check of psychomotor milestones and a parent-education session — substantial advantages for families who value continuous paediatric follow-up.

Private clinics and university teaching hospitals (CHU Ibn Rochd Casablanca, CHU Ibn Sina Rabat, CHU Mohammed VI Marrakech) also offer vaccination consultations integrated into general paediatric appointments by appointment. Public hospital fees remain moderate (50 to 150 dirhams depending on the patient's co-payment). Private clinics — Polyclinique du Maghreb in Casablanca, Clinique Agdal in Rabat, Clinique Internationale in Marrakech — charge between 400 and 800 dirhams per consultation. To find the nearest vaccination centre and verify real-time opening hours, the directory Vaccination centres Morocco lists all public and private structures with contacts, hours and reviews.

09Side effects: what is normal and what is not#

The vast majority of Moroccan schedule vaccines have an excellent tolerance profile. Local reactions (redness, induration, tenderness) are expected and last 24 to 72 hours. A moderate fever (38 to 39 °C) within 24 hours post-injection affects 20 to 30 % of infants after pentavalent or MMR, treatable with paracetamol 60 mg/kg/day in four divided doses. Irritability, transient anorexia and drowsiness are also part of the normal picture.

Certain manifestations must however prompt rapid paediatric consultation or a teleconsultation review: fever above 40 °C, febrile seizure, hypotonic-hyporesponsive episode (post-vaccinal vagal collapse with generalised hypotonia, pallor and transient unresponsiveness), persistent crying for more than three hours, generalised rash with facial oedema (sign of an allergic reaction), hot abscess at the injection site with centrifugal redness (suggestive of secondary bacterial infection). These events must be documented in the health booklet and reported via the Moroccan Centre for Anti-Poison and Pharmacovigilance (CAPM) to feed the national vaccine pharmacovigilance scheme.

True vaccine contraindications remain rare: a history of anaphylactic reaction to a previous dose of the same vaccine, severe immune deficiency for live vaccines (BCG, MMR, varicella, rotavirus), or evolving non-stabilised encephalopathy for pertussis. Simple rhinopharyngitis, moderate fever, eczema and breastfeeding are never contraindications to vaccination, contrary to persistent beliefs in some families. Postponing a vaccine for a banal cold exposes the child to a prolonged window of infectious risk and should be resisted.

10Catch-up: a child behind schedule#

A child behind schedule — whether by a few weeks for intercurrent illness, several months after a stay abroad, or several years in a child repatriated or adopted — can and must be caught up without starting over. The fundamental rule is that a documented previous vaccine dose remains valid regardless of the interval elapsed. It is never necessary to restart an interrupted vaccination schedule: one simply resumes at the next dose respecting the minimum interval between doses (generally 4 weeks for pentavalent and IPV, 4 weeks minimum between the two MMR doses).

The paediatrician establishes an individualised catch-up plan based on the child's current age, doses already received and documented, and priority vaccines to catch up. Children older than 5 who have never received certain vaccines can benefit from accelerated schedules. For MRE returning from Europe with a partially applied European schedule, the equivalence table is kept up to date by the Direction of Epidemiology and Disease Control (DELM) of the Ministry of Health.

No child should be denied vaccination because of delay. The simplest entry point remains the catch-up paediatric consultation, accessible via Sahha Live teleconsultation for an initial opinion and a pre-catch-up prescription, then in person for dose administration.

Article medically reviewed by Dr. Nadia Sebbar, paediatrician, on 2 June 2026.

Medical disclaimer: This content is informational and does not in any way replace an individual medical consultation or the official recommendations of the Moroccan Ministry of Health.