Vaccinations in Spain

We give an overview of immunization for children and adults, as well as travel-related vaccines and those for higher-risk groups in Spain.

If you live or work in Spain, you will have access to the country’s public healthcare system (asistencia sanitaria pública). This is undoubtedly one of the best in the world, and around 90% of the population currently uses it. All vaccinations in Spain are free of charge under the state health service and are recommended for babies and infants. And although they are not mandatory for children, a high percentage of people are in favor of them.

This guide explains all you need to know about vaccinations in Spain, including the following:

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The Spanish vaccination system

During the reign of Spanish King Charles IV in the late 18^th century, many members of the royal family became infected with the smallpox virus. He insisted the unaffected members of the family be vaccinated, and subsequently this was rolled out to the general population in November 1798. After the success of Spain’s inoculation program, the king issued a royal order to sponsor the Balmis-Salvany Expedition to take the vaccination to Spanish America and Asia. The Balmis-Salvany Expedition eventually helped to institutionalize worldwide vaccination boards for monitoring and evaluation purposes.

Currently, the official Spanish governing body for vaccinations is the Spanish Agency for Medicines and Health Products (Agencia Española de Medicamentos y Productos Sanitarios in Spanish), which publishes a recommended immunization schedule annually. Vaccinations are generally well-received by people in Spain.

Insurance for vaccinations in Spain

Spain is divided into 19 different official regional autonomous community areas, although each one has its own vaccination schedule that is based on national guidelines. The majority are available free of charge, though, under the state health service for children up to the age of 14 years old.

If you happen to be on holiday in Spain and need an emergency vaccination, all EU residents are generally entitled to free healthcare for the first three months of their stay by using their European Health Insurance Card.

For coverage of the vaccinations not included in the state health service, there are several private health insurance providers in Spain, such as:

• Allianz Care
• Cigna Global

Vaccinations for children in Spain

As a parent, it is important to understand what vaccinations are available for your child and which diseases they can help protect against. Each child up to the age of 14 is assigned a health record book via their pediatrician at the local health center (centro de salud).

All children can receive the following vaccinations in Spain:

• Hepatitis B: at two, four, and 11–12 months.
• Diphtheria, tetanus, and acellular pertussis vaccine: at two, four, and 11–12 months; additionally, a booster dose is provided anywhere between 12–18 years old.
• Inactivated Polio Virus vaccine (IPV): at two and four months; additionally, booster doses are provided at 11–12 months and six years old.
• Haemophilus influenzae type b conjugate vaccine (Hib): at two and four months; additionally, a booster dose is provided at 11–12 months.
• Pneumococcal conjugate vaccine (PCV): at two and four months; additionally, a booster dose is provided at 11–12 months.
• Meningococcal C conjugate vaccine (Men) and meningococcal ACWY conjugate vaccine (MenACWY): at four months, 12 months, and 12 years old.
• Measles, mumps and rubella vaccine (MMR): at 12 months and a second dose between two and four years old.
• Varicella vaccine (Var): at 15 months and a second dose between two and four years old.
• Human papillomavirus vaccine (HPV) (girls only): at 11–12 years old.
• Meningococcal B vaccine (Men): at two, four, and six months; additionally, a booster dose is provided between 12 and 15 months.
• Rotavirus vaccine (RV): at two, four, and six months.

Inoculations take place in primary care centers across Spain, with nursing staff administering the vaccines.

If your child was born outside of Spain, you’ll also need to inform your pediatrician about their vaccination history.

Vaccinations for special groups in Spain

For many years, the health authorities have recommended annual influenza vaccinations in Spain for the following groups:

• those above the age of 64 years old;
• those at any age who have medical disorders and are at increased risk for severe complications from influenza, such as healthcare workers and residents of nursing homes or other chronic care facilities.

If you are considered to be in a high-risk group, you are also eligible for free vaccinations.

According to the Spanish Paediatrics Association (AEPap), “every woman of childbearing age should be adequately immunized before pregnancy, so that during pregnancy she and the fetus do not suffer from any preventable disease.” And ideally, the woman should enter pregnancy immunized against measles, mumps and rubella, but not less than four weeks before the date of conception. During pregnancy, women are especially vulnerable to flu infections, so in any trimester of gestation and if this falls in the vaccination period of October to December, it is advisable to receive immunization against pertussis, diphtheria, and tetanus (Tdpa).

COVID-19 vaccinations in Spain

Vaccines against COVID-19 are free of charge for Spanish residents. The health ministry of each Autonomous Community (Comunidad Autónoma) decides how to administer vaccines, so check your local website to find out more about logistical details. While in some Comunidades you can be vaccinated without first making an appointment, you might need to bring a piece of ID to ensure your vaccination is properly registered.

To find out more about vaccinations against coronavirus in Spain, visit the Spanish government’s vaccination website. Otherwise, you can find more general information about the pandemic on the website of the Spanish Health Ministry.

Travel vaccinations in Spain

Although it is not necessary to receive any vaccinations to travel to Spain, there are many available if you are traveling to areas of the world that require them such as:

• Cholera
• Diphtheria, tetanus, and polio
• Hepatitis A
• Hepatitis B
• Japanese encephalitis
• Malaria tablets
• Meningococcus
• Mumps, measles, and rubella
• Rabies
• Tick encephalitis
• Tuberculosis
• Typhoid
• Yellow fever

Vaccination requirements for traveling to Spain may exist depending on your nationality; you should check with a Spanish embassy or consulate in your area before you arrive, to make sure.

You can also find more country-specific details on these diseases, such as where they are prevalent and what vaccines protect against them, from the European Commission Travel Advice.

Useful resources

Do you need further information on immunization and vaccinations in Spain? There are several useful guides that provide more details, such as:

• The Spanish Ministry of Health
• The Spanish Vaccination Association (in Spanish)