The word vaccination may evoke images of children getting an injection on their upper arm to immunise them from future infections. The need to have a similar system to immunise adults is yet to be addressed, especially in States such as Kerala, whose population of senior citizens is expected to surge in another decade.
According to the ‘India Ageing Report 2023’ of the UN Fund for Population Activities, about 22.8% of Kerala’s population will be senior citizens in 2036 as against the projected national average of 15%. In 2021, senior citizens constituted 16.5% of the State’s population.
“At present, there is no system or infrastructure for adult vaccination in the country like the Universal Immunisation Programme for kids. There is no vaccine schedule either. One of the reasons may be the high cost of these vaccines. As a first step, creating awareness on the issue is important,” says K.K. Purushothaman, Professor (paediatrics), MES Medical College Hospital, Perinthalmanna, Malappuram.
Public health experts say although there is not enough data on vaccine-preventable diseases among adults, they may be at risk during outbreaks. Other causes of concern are their waning immunity levels, age-related factors, demographic changes, and emergence of new diseases or new strains of existing illnesses.
A report of the Kerala State Vaccination Policy Committee led by B. Ekbal, submitted to the government in 2022, says adult immunisation is equally important, especially for those aged above 65. Recipients of solid organ transplants or stem cell transplants, those on cancer chemotherapy or immunosuppressants, and people suffering from primary or secondary immunodeficiency syndromes, chronic kidney, liver or pulmonary diseases, diabetes, congenital and acquired heart diseases etc too should be vaccinated.
The report says given the high mortality and morbidity due to influenza and pneumococcal infections such as pneumonia in the elderly, immunocompromised and those with comorbidities, those aged above 65 should be administered pneumococcal vaccine, 23 valent poly-sacccharide vaccine, and annual quadrivalent influenza vaccine. The proposals are yet to be implemented.
Dr. Purushothaman claims that free universal vaccination for adults may not be practical in the coming days. “The government can think of setting up a system in the public-private partnership mode. The private sector should procure the vaccines and the government machinery could be used for ensuring their quality, safety and efficacy. The government’s existing cold chain infrastructure could be used to safeguard the potency of the vaccines,” he suggests.
The healthcare institution offering vaccination for adults should ensure that the facility is available on the ground floor for easy access, says Dr. Purushothaman. “Preferably, a single-window system could be set up for check-up, documentation, and vaccination. There should be some space for taking rest as well,” he adds.
