Every year on November 10, World Immunization Day reminds us of the power of vaccines to protect lives across the lifespan. In India, while childhood immunisation under the Universal Immunisation Programme (UIP) has made great strides, adult immunisation remains under-acknowledged. With a rapidly ageing population, rising prevalence of chronic diseases, and increased vulnerability to vaccine-preventable infections, the need for adult immunisation as part of a "life-course" vaccination strategy is becoming urgent. Adult vaccines not only protect individuals, but also bolster community immunity, reduce healthcare costs, and enable working-age adults to remain productive. Yet in India, adult vaccine-coverage is very low and awareness remains limited. According to various reviews, the only nationally mandated adult vaccine (apart from tetanus in pregnancy) is lacking clear national guidelines.
On World Immunization Day 2025, let's explore how adult vaccines can help protect India, by examining the evidence, outlining current status and gaps, and discussing what can be done to scale up adult vaccination across the country.
Why adult immunisation matters in India
Vaccines are recognised globally as among the most cost-effective public-health interventions. The World Health Organization (WHO) includes adult immunisation schedules in its guidance for "all age groups - children, adolescents, adults". (World Health Organization) In India, a narrative review found that although the burden of vaccine-preventable diseases (VPDs) among adults is not well quantified, adults are increasingly vulnerable due to waning immunity, age-related immune decline, and chronic conditions.
An economic analysis reported that adult vaccination programmes can deliver returns of up to 19 times the initial investment, when the full societal and health-system benefits are considered. In the Indian context, the Observer Research Foundation (ORF) highlights that harnessing adult immunisation can yield long-term health and economic gains for a country with a large working-age population.
What vaccines are recommended for adults
Several guidelines in India (by medical societies) list key vaccines for healthy adults and at-risk groups. A review summarises that healthy adults should consider influenza (over 50 yrs), pneumococcal (above 65 yrs), zoster (above 60 yrs), HPV (9-26 yrs), DPT/Td boosters, MMR, among others. Another earlier review lists diphtheria/tetanus/pertussis (Td/Tdap), hepatitis B, influenza, pneumococcus, HPV, and others.
In India, official national adult immunisation guidance is limited. Historically, the only adult-vaccine mandated beyond childhood schedule was tetanus toxoid (TT) in pregnancy. However, a draft booklet of Indian Consensus Guidelines identifies several vaccines for adults, including influenza, pneumococcus, zoster, hepatitis B and HPV.
Current status and gaps in India
Despite the evidence and guidelines, adult immunisation uptake remains low. A media report noted only 16 % of adults over age 50 in India reported any adult vaccination in one survey. Key barriers include lack of national programme and funding, low awareness among providers and the public, vaccine hesitancy, accessibility issues, and limited data on disease burden in adults. (ResearchGate)
The 2024 review by API and others emphasises that the geriatric population (projected to be around 20% by 2050) needs adult immunisation to prevent preventable morbidity and mortality. (IJCMPH) Yet, outreach remains weak. Establishing adult vaccination clinics and integrating adult immunisation into primary-care services has been proposed.
How adult vaccines protect individuals and society
- Influenza and pneumococcal vaccines: These respiratory-pathogens impose high burdens in older adults. Vaccination reduces hospitalisations, complications and deaths. India's guidelines recommend influenza for adults over 50 and pneumococcal over 65.
- HPV (human papilloma virus) vaccine: While often framed as adolescent vaccine, catch-up vaccination in adults and vaccination for at-risk groups helps reduce cervical and other cancers. The guidelines list HPV for 9-26 yrs; but adult catch-ups have value.
- Zoster (shingles) vaccine: Over the age of 60, zoster vaccine helps prevent herpes zoster and its complications (post-herpetic neuralgia). Guidelines list zoster for those aged below 60 years.
- Td/Tdap boosters: Even for diseases like diphtheria, pertussis and tetanus, adult booster doses are required. For example, for adults 18-64 who completed childhood schedule, a Td booster every 10 yrs is indicated.
By preventing disease, adult vaccines reduce healthcare utilisation, lost productivity, and help maintain a healthy workforce, which is particularly important for India's growing economy and ageing population.
On World Immunization Day 2025, the spotlight on adult vaccines comes at the right time for India. With a changing demographic profile, rising chronic conditions and the threat of vaccine-preventable infections among adults, it is essential to shift from a childhood-only immunisation mindset to a life-course approach. Adult vaccination not only protects the individual but safeguards communities, supports healthcare systems, enhances productivity and builds resilience. Moving ahead, a concerted push, from policy frameworks, provider education, public awareness, and service delivery, can unlock the health and economic benefits of adult immunisation for India. This November 10, let us commit to ensuring that vaccination isn't just a childhood milestone, but a lifelong one.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your doctor for more information. NDTV does not claim responsibility for this information.
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