Spanish Vaccine Schedule and Adult Boosters for Expats

1. The Spanish vaccination system — how it works

Spain runs one of Europe's most respected immunisation programmes, with childhood vaccination coverage consistently above 95% for the core antigens — well ahead of the WHO target. The framework is set nationally by the Ministerio de Sanidad through the Consejo Interterritorial del Sistema Nacional de Salud, which agrees a common schedule, and then delivered by each of the 17 autonomous communities through their regional health services (SAS in Andalucía, CatSalut in Catalunya, SERMAS in Madrid, and so on).

The official national calendar is published and updated each year at sanidad.gob.es — Calendario común de vacunación a lo largo de toda la vida. Since 2019 Spain has explicitly framed the schedule as a lifetime calendar rather than just a childhood one, with separate sections for children, adolescents, adults and risk groups.

What is free on the SNS

• All scheduled childhood vaccinations from birth to 14 years
• Adolescent boosters at 12 and 14
• HPV vaccine for boys and girls at age 12 (rolled out for boys from 2023)
• Annual flu jab from age 60 (lowered from 65 in most regions) and for risk groups of any age
• Pneumococcal and herpes zoster (shingles) for the 65 cohort
• Tetanus-diphtheria (Td) boosters at age 65 and after injuries when due
• COVID-19 boosters for risk groups under the seasonal strategy

Travel vaccines and most adult catch-up doses outside the risk-group criteria are paid, either through the SNS international vaccination centres at cost price or through a private provider. This is where private cover with Sanitas or Caser changes the maths — see Section 10.

2. Calendario vacunal infantil — the 0–14 childhood schedule

The common childhood schedule below is the 2026 version agreed by the Consejo Interterritorial. Some communities offer slightly earlier or expanded options (for example, MenB in Castilla y León and Catalunya), but the table is universal across Spain.

The calendar is delivered through your child's pediatra at the local centro de salud. Appointments are scheduled automatically by SMS or in the digital health record (e.g. ClicSalud+ in Andalucía, Mi Salud in Aragón, La Meva Salut in Catalunya).

3. Catch-up vaccinations for expat children

If you arrive in Spain mid-schedule — from the UK, Ireland, the US, Australia or anywhere else — the pediatra will assess your child's existing record against the Spanish calendar and design a pauta acelerada (catch-up schedule) free of charge.

What to bring to the first appointment

• Original vaccination record (UK red book, Irish PHN record, Australian AIR statement, US CDC card, etc.)
• Translation is helpful but not required — pediatras read INN names and standard abbreviations across languages
• Empadronamiento certificate and TSI (tarjeta sanitaria individual)
• Passport / DNI / NIE

The pediatra will record everything in the regional electronic vaccination record (RVE) and issue any missing doses on the spot or at a follow-up. Common gaps for British and Irish arrivals include the MenB primary series (only added to the NHS schedule in 2015) and varicella, which Spain vaccinates universally but the NHS does not.

For US arrivals, the main differences are that Spain uses hexavalent combinations earlier and does not routinely give hepatitis A in the universal schedule (only in Ceuta, Melilla, Catalunya and risk groups). For Australian arrivals, the schedules are very close; expect to top up MenB if the child was vaccinated under an older Australian state programme.

4. Adult boosters — td, flu, pneumococcal, shingles

Spain's adult vaccination calendar is the section most expats overlook. The full lifetime schedule and risk-group annexes are published at the Ministerio de Sanidad portal. The key adult doses are summarised below.

The 10-year Td booster — the one most expats miss

Spain operates a strict 10-year recall for the Td (tetanus-diphtheria) combined adult vaccine. After completing the childhood series, adults should receive boosters at approximately ages 25, 35, 45, 55 and 65. If you arrived in Spain in your 30s or 40s and your last UK or Irish booster was when you left school, you are almost certainly due. The centro de salud nurse will administer it free; the regional electronic record (RVE) tracks the 10-year interval automatically.

Flu vaccine — the annual campaign

The Spanish flu campaign runs each autumn, typically from late September to mid-December. Eligible groups receive it free at the centro de salud or, increasingly, at the pharmacy under regional pilots (Andalucía, Madrid, Comunidad Valenciana, Cantabria, Murcia, Galicia). Outside the eligible groups, you can pay privately at any pharmacy or vaccination clinic for around €15–€25 a dose.

Pneumococcal in adults

The standard adult schedule from 2024 onwards is a single dose of PCV20 (Prevenar 20) at age 65, replacing the older PCV13+PPSV23 sequence. Risk groups under 65 (chronic heart, lung or kidney disease, diabetes requiring medication, asplenia, immunosuppression) are eligible from age 18.

Herpes zoster (shingles, HZ)

The recombinant zoster vaccine (RZV, brand name Shingrix), in a 2-dose schedule 2–6 months apart, is included free in the calendar for adults turning 65 and for at-risk adults from age 18. Privately, the course costs around €300–€400. Cover is generally lifelong; a booster is not currently recommended.

5. HPV vaccine — women, men and adult catch-up

The HPV vaccine has been part of the Spanish calendar for girls since 2007. From the 2022–2023 academic year, Spain extended free universal HPV vaccination to boys aged 12, in line with European Centre for Disease Prevention and Control (ECDC) recommendations. The vaccine used nationally is the 9-valent Gardasil-9 in a 2-dose schedule.

Catch-up for adolescents and young adults

Most regions fund free catch-up for unvaccinated girls and boys up to age 18, and some (Catalunya, Navarra, País Vasco) go further. Above the catch-up age, HPV vaccination is available privately for around €150–€200 per dose (2 doses up to age 14, 3 doses thereafter).

Adult HPV vaccination — is it worth it?

The World Health Organization (WHO) and ECDC recognise benefit up to age 26 unambiguously and a more limited benefit up to age 45 in adults likely to acquire new HPV exposures. The decision is individualised; Spanish private gynæcology practice commonly offers it to women up to 45.

6. COVID-19 booster strategy in 2026

Spain has fully integrated COVID-19 boosters into the autumn vaccination campaign alongside the flu jab. The current strategy (autumn 2026) follows the recommendations of the Ponencia de Programa y Registro de Vacunaciones and is updated each year — check sanidad.gob.es — vacunación COVID-19 for the live recommendation.

Who is offered the free COVID-19 booster

• Adults aged 60 and over
• Residents of care homes and other long-term-care institutions
• Adults and children from 6 months in clinical risk groups (immunosuppression, transplant, chronic heart/lung/kidney disease, neurological conditions, complex disability)
• Pregnant women in any trimester
• Healthcare workers and carers of high-risk individuals
• Household contacts of severely immunosuppressed people

The booster is the variant-adapted formulation matched to the dominant circulating lineage, typically administered same-visit with the flu jab in different arms. Healthy adults outside the risk groups are not actively offered a booster but can usually access one through private channels.

Private COVID-19 vaccination

Outside the eligible groups, a private dose typically costs €50–€90 at a vaccination clinic or international vaccination centre. Sanitas and Caser members should check their policy schedule, as some 2026 products include adult flu and COVID vaccination as part of preventive cover (Section 10).

7. Travel vaccinations and Yellow Fever centres

Travel vaccinations are handled separately from the routine calendar, through the network of Centros de Vacunación Internacional (international vaccination centres) operated by the Ministerio de Sanidad in every province. The official directory is at sanidad.gob.es — Centros de Vacunación Internacional.

What the centro de vacunación internacional does

• Provides Yellow Fever vaccination — only WHO-authorised centres can issue the International Certificate of Vaccination (ICVP, the "yellow card") required for entry to many sub-Saharan African and South American countries.
• Issues other travel vaccines: hepatitis A, typhoid, rabies (pre-exposure), Japanese encephalitis, cholera, MenACWY for Hajj/Umrah, tick-borne encephalitis.
• Provides destination-specific medical advice including malaria prophylaxis prescriptions.
• Updates entry requirements based on WHO and ECDC surveillance.

Typical prices at SNS international centres (2026)

Booking ahead

Demand at the SNS international centres can mean a 4–6 week wait, especially May–August. Book as soon as your tickets are confirmed via the centre's online portal or by phone. Private travel clinics — some run by Sanitas and Caser network providers — offer next-day appointments at a small premium.

8. Where to get vaccinated — SNS, private and pharmacies

Centro de salud (public)

Your local centro de salud is the default for almost every routine vaccination — childhood schedule, adolescent doses, adult boosters and seasonal campaigns. Appointments are booked through the regional health app or by phone, and the nursing team (enfermería) handles administration. Walk-ins are accepted in many regions for the autumn flu campaign.

Private clinics and hospitals

For travel vaccines outside the SNS network, off-label adult HPV, optional shingles cover for under-65s and same-day appointments, private vaccination clinics — including Sanitas and Caser network providers — are widely used. Prices are transparent and consistent across major chains.

Pharmacy vaccination — the growing channel

Spain has progressively expanded the pharmacist's role in vaccine administration. Under regional pilots and permanent programmes, qualified pharmacists can now administer the flu and COVID-19 vaccine in Andalucía, Madrid, Comunidad Valenciana, Murcia, Galicia and Cantabria, with more regions due to follow in 2026. This is particularly useful for working adults who struggle to get a centro de salud appointment during the autumn campaign.

9. Vaccination records, certificates and translations

Spain maintains a unified electronic vaccination record (Registro de Vacunaciones, RVE) shared across the SNS, accessible through your regional health portal. From there you can download:

• Your complete vaccination history (historial de vacunación) as a PDF
• An EU Digital COVID Certificate (still issued for travellers to countries that require it)
• Individual certificates for school, work or visa applications
• The International Certificate of Vaccination (ICVP) for Yellow Fever — issued in paper form at the centro de vacunación internacional

Regional portals include: ClicSalud+ (Andalucía), La Meva Salut (Catalunya), Tarjeta Sanitaria Virtual / Mi Madrid Salud (Madrid), Mi Salud (Aragón), Osakidetza app (País Vasco), Carpeta Ciudadana (cross-cutting central portal at carpetaciudadana.gob.es).

For new arrivals translating a foreign record

The centro de salud will record your existing vaccinations in the RVE without requiring a sworn translation. If you need a certified Spanish translation for a school admission or work medical, the Ministerio de Asuntos Exteriores list of sworn translators (traductores jurados) is at exteriores.gob.es.

10. Sanitas vs Caser — vaccine cover compared

Vaccine cover under private Spanish health insurance varies considerably between products and is one of the more confusing areas of policy comparison. The summary below reflects the two providers we recommend for expat families — Sanitas and Caser Salud — based on their 2026 product schedules. Always check the conditions of your specific policy as inclusions change year to year.

For a family of four with school-age children, the value of private cover for vaccines tends to come from access rather than headline savings — same-week appointments for flu and COVID boosters, direct billing at network paediatric clinics, and preventive consultations alongside the GP visit. Travel vaccines remain mostly out-of-pocket regardless of insurer.

11. Practical tips for expat families

• Register with a pediatra immediately after empadronamiento. The vaccination clock in Spain runs against the calendar, not the doctor.
• Bring the original vaccination record (UK red book, US CDC card, Australian AIR statement) to the first appointment. Photos are fine if originals are at home.
• Diarise the 10-year Td booster. Centros de salud generally call you, but moves and SMS gaps mean adults miss it. Self-track and ask the nurse.
• Check the autumn flu campaign dates for your region in late September. Pharmacy and walk-in options vary by autonomous community.
• Book travel vaccines 6–8 weeks ahead. Yellow Fever is a single lifetime dose; hepatitis A needs at least 2–4 weeks before exposure for full cover.
• Keep an EU vaccination certificate PDF on your phone — useful for school admissions, employer medicals and onward EU travel.
• Don’t double up. The pediatra/nurse will sort out what your child already has and what is missing — do not re-vaccinate from scratch.
• For grandparents visiting, check Spain’s flu and COVID eligibility — visitors 60+ on long stays can often access the autumn campaign privately at modest cost.

12. FAQs and official resources

Is the Spanish childhood vaccination schedule free for expat children?

Yes — for any child registered with the SNS through empadronamiento and a tarjeta sanitaria, the full calendario vacunal infantil is delivered free at the centro de salud, including catch-up doses for late arrivals.

How often do I need a tetanus booster in Spain?

Adults who have completed the primary series need a Td (tetanus-diphtheria combined) booster every 10 years until age 65, with a typical lifetime total of 5 adult doses. After 65, no further routine boosters are recommended unless after a tetanus-prone injury.

Is the flu vaccine free for over-60s?

Yes in most autonomous communities for the 2026 campaign — the age threshold was lowered from 65 to 60 in line with WHO and ECDC guidance. Risk groups of any age remain eligible.

Can men get the HPV vaccine free in Spain?

Yes for boys aged 12 since the 2022–2023 cohort. Catch-up cover for older unvaccinated boys is funded up to age 18 in most regions. Adult HPV vaccination beyond catch-up is privately paid.

Where do I get a Yellow Fever vaccine?

Only at a WHO-authorised Centro de Vacunación Internacional listed on the Ministerio de Sanidad portal. Vaccines from elsewhere do not produce a valid ICVP.

Does Sanitas or Caser cover travel vaccines?

Generally no — travel vaccines are not part of standard private Spanish health insurance. Use the SNS international centre or a private travel clinic, and pair with a travel insurance policy that covers trip-related medical exposure.

How do I download my Spanish vaccination record?

From your regional health portal (ClicSalud+, La Meva Salut, Mi Salud, Tarjeta Sanitaria Virtual, etc.) or through the cross-cutting central portal Carpeta Ciudadana. The PDF is recognised across the EU.