Vaccination in Peru: is it mandatory, and can you refuse?

Yes, the law says “mandatory”

Law 28010, Peru’s General Vaccine Law, is short. Article 1:

“Declárase las actividades de vacunación obligatoria para la Salud Pública Nacional por su elevado impacto en la prevención y control de las enfermedades prevenibles por vacunación.”

(Vaccination activities are declared mandatory for national public health, because of their high impact on preventing and controlling vaccine-preventable diseases.)

Article 2 puts the Ministry of Health (MINSA) in charge of the schedule:

“El Ministerio de Salud en su calidad de ente rector es el responsable de establecer la sectorización y el calendario de vacunación, así como de vigilar su cumplimiento.”

(The Ministry of Health sets the vaccination schedule and monitors compliance.)

The General Health Law (Law 26842) goes the same way. Article 80 limits exceptions:

“Sólo por razones médicas o biológicas podrá establecerse excepciones a la vacunación y revacunación obligatorias, establecida por la Autoridad de Salud de nivel nacional.”

(Exceptions to mandatory vaccination and revaccination may be set only for medical or biological reasons.)

So the law has no exemption for religious, philosophical or personal beliefs. Only a medical or biological reason, such as a contraindication.

Article 79 requires everyone to follow the health authority’s measures against communicable diseases:

“La Autoridad de Salud queda facultada a dictar las medidas de prevención y control para evitar la aparición y propagación de enfermedades transmisibles. Todas las personas naturales o jurídicas, dentro del territorio, quedan obligadas al cumplimiento de dichas medidas, bajo sanción.”

(Everyone in the country must comply with those measures, “under sanction”.)

The article says “under sanction” but does not say which. In the norms we read, we found no specific fine or penalty for not getting vaccinated or not vaccinating your children.

But they need your signature

This is the part most people miss. The current technical standard, NTS No. 246-MINSA/DGIESP-2026, defines consent to vaccination like this:

“Conformidad expresa del padre, madre, personal de apoyo o de confianza, para que su familiar o el mismo, reciba la vacuna y/o inmunización en forma libre, voluntaria y consciente, después de haber sido informado sobre la vacuna o inmunización incluyendo los riesgos reales/ potenciales, efectos colaterales, efectos adversos, así como los beneficios. Debiendo ser registrado y firmado en un documento por el padre, madre, personal de apoyo o de confianza y el profesional responsable de la atención.”

(Express agreement by the person, or by a parent or support person for a family member, to receive the vaccine freely and voluntarily, after being told the risks, side effects and benefits. It must be recorded and signed by that person and by the health professional.)

This matches the General Health Law’s general rule (article 15.4, as amended by Law 29414): everyone has the right to give free, informed consent before any procedure. The same rule contains the exception that matters for vaccines:

“Quedan exceptuadas del consentimiento informado las situaciones de emergencia, de riesgo debidamente comprobado para la salud de terceros o de grave riesgo para la salud pública.”

(Informed consent is not required in emergencies, in cases of proven risk to others’ health, or of serious risk to public health.)

The result: vaccination is mandatory as a public-health policy, but in routine care the facility informs you and asks you to sign. In an outbreak or other serious public-health risk, the law allows consent to be set aside. This is our reading of how the rules fit together; none of them says it in one sentence.

Which rule applies now, and what it covers

In June 2026, Ministerial Resolution No. 561-2026/MINSA approved NTS 246 and revoked the previous one:

“Artículo 1.- Aprobar la NTS N° 246 -MINSA/DGIESP-2026 “Norma Técnica de Salud que establece el Esquema Nacional de Inmunizaciones”, que como Anexo forma parte integrante de la presente Resolución Ministerial. Artículo 2.- Dejar sin efecto las Resoluciones Ministeriales N° 884-2022/MINSA, N° 099-2023/MINSA, N° 218-2024/MINSA, N° 474-2025/MINSA, N° 709-2025/MINSA y N° 403-2026/MINSA.”

(Article 1 approves NTS 246. Article 2 revokes R.M. 884-2022/MINSA, which had approved NTS 196, and all the resolutions that amended it.)

If a guide, school or clinic cites NTS 196, it is relying on a standard that is no longer in force.

NTS 246 binds every facility that vaccinates, public or private:

“La presente Norma Técnica de Salud es de aplicación y cumplimiento obligatorio en todos los establecimientos de salud públicos (del Ministerio de Salud, Seguro Social de Salud – EsSalud, Sanidad de las Fuerzas Armadas, Sanidad de la Policía Nacional del Perú, Instituto Nacional Penitenciario - INPE y Gobiernos Regionales) y privados del Sector Salud que realicen actividades de inmunizaciones.”

(It applies to MINSA, EsSalud, the armed forces and police health services, prison health services, regional governments, and private health facilities that vaccinate.)

It sets the scope of the schedule:

“El Estado Peruano, mediante el MINSA, garantiza la compra y distribución de 23 vacunas del esquema regular, 01 anticuerpo monoclonal y 04 vacunas según situaciones epidemiológicas. Este esquema busca proteger a la población contra 36 enfermedades inmunoprevenibles, asegurando el abastecimiento desde el nivel nacional, al nivel regional, para cada curso de la vida.”

(The State guarantees 23 routine vaccines, 1 monoclonal antibody and 4 vaccines used according to the epidemiological situation, covering 36 vaccine-preventable diseases across all life stages.)

Scheduled vaccines are free:

“Las vacunas y jeringas que se usan en la actividad regular y complementaria de inmunizaciones, son adquiridas por el gobierno peruano con fondos del Tesoro Público y se otorgan de manera gratuita a toda la población beneficiaria del presente Esquema Nacional de Inmunizaciones, por el profesional de enfermería.”

(Vaccines and syringes are bought with public funds and given free to everyone covered by the National Schedule.)

Adults

NTS 246 organises the schedule by life stage: pregnancy, children, adolescents, young people, adults and older adults. For an adult, in practice:

• Which vaccines apply to you depends on your age and situation (pregnancy, working in health care, conditions that weaken the immune system). Ask your health centre which ones you are missing.
• You will be asked for signed informed consent.
• Only a medical or biological reason legally exempts you from a mandatory vaccine.
• The COVID-19 vaccine is no longer on the routine schedule. NTS 246 lists it among the vaccines used according to the epidemiological situation and says:

“Para COVID-19, Viruela del Mono (MPOX), Dengue, Antirrábica Humana, el manejo es de acuerdo a sus documentos normativos vigentes.”

(COVID-19, mpox, dengue and human rabies vaccines are handled under their own rules in force.)

Children and adolescents

Which vaccines they get

The children’s schedule (section 6.2.2 of NTS 246) includes, among others: BCG, hepatitis B, pentavalent or hexavalent, inactivated and oral polio, rotavirus, pneumococcal, paediatric influenza, measles-mumps-rubella (SPR), chickenpox, yellow fever (AMA), hepatitis A, DPT and the human papillomavirus (HPV) vaccine. It also includes a monoclonal antibody against respiratory syncytial virus for newborns and infants. Here is one row of the table, for the twelve-month visit:

“12 meses Vacuna Sarampión, Paperas, Rubéola (SPR) 1ra. Dosis Vacuna Neumococo 3ra. Dosis Vacuna contra la Varicela 1ra. Dosis Vacuna Influenza Pediátrica Dosis única”

(At twelve months: first MMR dose, third pneumococcal dose, first chickenpox dose, and a paediatric flu dose.)

We do not reproduce the full table of ages and doses. Confirm your child’s dates with the health centre and the child’s card:

“El personal de la salud entrega el carné de Atención Integral del Niño y la Niña menor de 5 años en el cual está incorporado el esquema nacional de inmunizaciones donde se registra y acredita las vacunas administradas.”

(Health staff give out the child health card for children under 5, which includes the national schedule and records and certifies each vaccine given.)

Can parents refuse?

For routine vaccination, the person who signs consent for a child is the mother or father (as the NTS 246 definition says). But parental refusal is not unlimited. Three rules restrict it:

1. Refusal on behalf of a child involves the public prosecutor and does not stand if it puts public health at risk. Article 17 of the regulation of Law 29414 (Supreme Decree 027-2015-SA):

“En caso de menores de edad o de personas cuyas condiciones particulares le impidan ejercer este derecho, se realiza conforme a lo señalado en el artículo 5 del presente Reglamento, con la participación del Ministerio Público, teniendo en cuenta que los que no gozan de autonomía plena requieren protección. La negativa a recibir o continuar el tratamiento no procede cuando la persona usuaria del servicio de salud se encuentre en estado de emergencia o esta decisión ponga en riesgo la salud pública.”

(For minors, refusal goes through their legal representatives with the participation of the Ministerio Público. Refusal does not stand in an emergency or when it puts public health at risk.)

2. If parents refuse treatment, the doctor must tell a judge. Article 4 of the General Health Law:

“En caso que los representantes legales de los absolutamente incapaces o de los relativamente incapaces, a que se refieren los numerales 1 al 3 del Artículo 44 del Código Civil, negaren su consentimiento para el tratamiento médico o quirúrgico de las personas a su cargo, el médico tratante o el establecimiento de salud, en su caso, debe comunicarlo a la autoridad judicial competente para dejar expeditas las acciones a que hubiere lugar en salvaguarda de la vida y la salud de los mismos.”

(If a minor’s legal representatives refuse medical or surgical treatment, the doctor or facility must report it to the courts so that action can be taken to protect the child’s life and health.)

An honest caveat: the article speaks of “tratamiento médico o quirúrgico” (medical or surgical treatment). No rule we read says expressly whether a preventive vaccine falls under it.

3. When a suspected case appears in your area, a child with an incomplete schedule is vaccinated. In its definition of a documented vaccination block (bloqueo vacunal), NTS 246 says:

“De identificarse un niño con esquema de vacunación incompleto se procederá a vacunar al menor; esta actividad se realiza en coordinación con el área de epidemiología.”

(If a child with an incomplete schedule is found, the child will be vaccinated, in coordination with the epidemiology team.)

The general rules on how far parents can decide about a child’s health are on medical decisions for a minor child.

What about school enrolment?

The current enrolment rules are in Ministerial Resolution No. 010-2026-MINEDU. They apply to public and private schools, and they do not mention a vaccination card or any vaccine. For children entering the system aged six or under, they are explicit:

“a) Si, al 31 de marzo del año en que se solicita la matrícula, el niño tiene seis (06) años o menos, solo se debe presentar los documentos señalados en el punto VI.2 de la presente norma, y brindar los datos para el rellenado de la FUM. La IE o programa no puede condicionar la matrícula a la rendición de un examen de ingreso, admisión u otro tipo de evaluación directa al menor, ni entrevistas u otros a su representante legal. Tampoco se puede condicionar la matrícula a la presentación de documentos adicionales a los señalados en el párrafo previo”

(If the child is six or under on 31 March, only the documents in section VI.2 and the enrolment form data are required. No entrance exam or interview, and enrolment cannot be made conditional on any other document.)

Among the school’s duties:

“p) Solicitar al estudiante, o a su representante legal, únicamente los requisitos establecidos en la presente norma.”

(Ask the student or their representative only for the requirements set in these rules.)

Our reading: a school may ask to see the card, for example to coordinate a vaccination campaign with the health centre, but it cannot refuse enrolment or make it conditional on the card. If it does, ask for the legal basis in writing and go to the local education office (UGEL). If the school also charges you something improper, see improper school charges.

If something goes wrong

• If you were charged for a scheduled vaccine, or vaccinated without being informed or asked to sign, complain to the facility and then to SUSALUD: patient complaints to SUSALUD.
• Your general rights as a patient, including consent and medical records, are on informed consent and medical records.

What this page does not cover

• Each vaccine’s technical sheet (doses, intervals, contraindications) and the annexes of NTS 246.
• The specific rules for the COVID-19, dengue, mpox and human rabies vaccines.
• Whether an employer can require workers, including health workers, to be vaccinated.
• Vaccination requirements for travelling abroad or entering Peru.
• The exact procedure before the public prosecutor or a judge when parents refuse, and court rulings on vaccination cases.
• What specific penalty, if any, applies to someone who is not vaccinated: the law says “under sanction” but we did not find the rule that sets it.