A lack of awareness among doctors as well as the general public, out-of-pocket expenses, vaccine hesitancy and complacency are the barriers plaguing adult vaccination in India, a doctor said on Sunday.
While the universal immunisation programme has covered the vaccination of children over the last several years, the burden of vaccine-preventable diseases has now shifted to the adult population and thus arises the need to vaccinate them, said Chandramouli Bhattacharya, an infectious diseases specialist at Peerless Hospital.
“We need to educate the physicians first. They must recognise the need for adult vaccination and have the ability to give the vaccines safely. Education of the general population is also vital. We need to go out into the community,” Bhattacharya said at Medicon International, a medical conference on advancements in treatment, held at a city hotel on Sunday.
Some of the other barriers against adult vaccination are “reluctance aided by a lot of misinformation, complacency, inconvenience to take out time for vaccines and lack of trust,” he said.
India’s ageing population, for which comorbidity poses a big challenge, will benefit from adult vaccination, stated experts.
Balram Bhargava, former director-general of the Indian Council of Medical Research (ICMR), said vaccination is vital for the elderly, immunocompromised and those with heart conditions.
“They should take the pneumococcal and influenza vaccines,” said Bhargava, also a former secretary of the department of health research under union health
ministry.
Public health expert Abhijit Chowdhury also emphasised the need for vaccination among people with comorbidities. “An average person with good immunity may not need it, but a comorbid individual will benefit from it,” said Chowdhury.
Bhargava and Chowdhury were not part of Medicon International. Metro spoke with them separately.
At the conference, Bhattacharya flagged “out-of-pocket expense” as a barrier plaguing adult vaccination.
Contrary to child vaccination, which is free under the universal immunisation programme, the cost of adult vaccination has to be borne by the individual.
The ministry of health and family welfare’s website mentions that India’s universal immunisation programme “targets 3.04 crore pregnant women and 2.7 crore newborns annually”.
Under the programme, immunisation is being provided free of cost against 12 vaccine-preventable diseases — diphtheria, pertussis, tetanus, polio, measles, rubella, severe form of childhood tuberculosis, rotavirus diarrhoea, hepatitis B, meningitis and pneumonia caused by Haemophilus influenzae type B, pneumococcal pneumonia and Japanese Encephalitis (only in endemic districts).
With ageing, natural disadvantages like immunosenescence, where the immune system becomes less able to mount a response against pathogens, are inevitable. Antimicrobial resistance and toxicity are other disadvantages.
Bhattacharya recommended adult vaccination against shingles, pneumonia, influenza and human papillomavirus, which causes certain kinds of cancer.
“The PCV 20 is the recommended vaccine against pneumonia and meningitis. WHO recommends the pneumococcal vaccine for anyone who is 65 years or above,” said Bhattacharya.
Influenza vaccines are recommended once annually, as the virus strain changes
frequently.
“In Calcutta, May-June is the ideal time to get vaccinated against influenza,” he said.
“The WHO strongly recommends HPV vaccines when a child is between 11 and 12 years. If missed, then it can be taken till 26. Once someone attains 27 years of age, HPV vaccines are recommended on a case-by-case basis,” he said.
The vaccine protects against certain types of human papillomavirus (HPV) infections that can cause various cancers and genital warts.