Towards adult vaccination in India: a narrative literature review. Issue 4 (2nd April 2020)

• Record Type: Journal Article
• Authors: Dash, Resham; Agrawal, Ashish; Nagvekar, Vasant; Lele, Jayesh; Di Pasquale, Alberta; Kolhapure, Shafi; Parikh, Raunak
• Is Part Of: Human vaccines & immunotherapeutics. Volume 16:Issue 4(2020)
• Page Start: 991
• Page End: 1001
• Publication Date: 2020-04-02
• Subjects: Adult immunization -- India -- guidelines -- immunosenescence -- barriers -- life-course immunization -- vaccination coverage; Vaccines -- Periodicals; 615.372
• DOI: 10.1080/21645515.2019.1682842
• Languages: English
• ISSNs: 2164-5515

Abstract

ABSTRACT: Despite vast improvements in childhood vaccination coverage in India, adult vaccination coverage is negligible. Our aim was, therefore, to create awareness about the importance of adult immunization. Although the true burden of vaccine-preventable diseases (VPDs) among Indian adults is unknown, adults are particularly vulnerable during outbreaks, due to a lack of immunization, waning immunity, age-related factors (e.g. chronic conditions and immunosenescence), and epidemiological shift. There are no national adult immunization guidelines in India, and although several medical societies have published adult immunization guidelines, these vary, making it unclear who should receive which vaccines (based on age, underlying conditions, etc.). Other barriers to adult immunization include vaccine hesitancy, missed opportunities, and cost. Steps to improve adult vaccination could include: adoption of national guidelines, education of healthcare providers and the public, and promotion of life-course immunization. Improving adult vaccine coverage could help reduce the burden of VPDs, particularly among older adults. PLAIN LANGUAGE SUMMARY: What is the context? In developing countries such as India, vaccine-preventable diseases cause a high incidence of disease and related deaths, even among adults. Unvaccinated adults also act as a reservoir of infection for vulnerable populations (e.g. infants) and can indirectly contribute to disease transmission. Adult immunization is a neglected and under-addressed aspect of Indian health policy. What is new? We provide a comprehensive overview of adult immunization, particularly barriers to vaccination. We highlight the need for, and benefits of, adult vaccination and emphasize the importance of "life-course immunization". What is the impact? Improving adult vaccination coverage in India, particularly for older adults, could help break the chain of infection and reduce the burden of disease among patients with chronic conditions and the wider community. Specifically, better coverage could result in reduced incidence rates, hospital admissions, health costs, and an improved quality of life.