World Immunization Day – Immunizing Adults in India

Immunization is a process to make a person immune to an infectious disease. The process is typically carried out through the administration of vaccines. It is achieved by stimulating the immune system of the body to protect the person against an illness or a disease. Immunization is one of the most beneficial and cost-effective measures to prevent vaccine-preventable diseases. Global eradication of smallpox and partial eradication of polio speaks of the success of immunization. While people often associate immunization with infants and children, the fact is that it is equally important for adults. Therefore, adult immunization should not be neglected and underpublicized.

Just like childhood vaccination, adult vaccination also plays a vital role in reducing the number of cases related to acquired illnesses. Vaccination is crucial to increase the effectiveness of childhood vaccines, improve immunity against the newer form of comorbidities and to boost the exiting immunity. Furthermore, vaccination is also important for ladies who are pregnant or planning to conceive. Timely immunization can help them to avoid complications during pregnancy and childbirth.

Vaccines for recommended for all adults

Diphtheria, Tetanus, (TD) and Acellular Pertussis 31 (TDAP) Vaccine

Td (Tetanus and Diphtheria) vaccine is advised to adults who have completed their primary vaccination series. Td vaccine should be repeated after every 10 years until the age of 65 years. In place of Td vaccine, Tdap (and Tdap ((Tetanus, Diphtheria and Acellular Pertussis) should be administered at least once in adults whose DPT immunization status is unknown.

Human Papillomavirus (HPV) Vaccine

Vaccines against Human Papillomavirus are available as a quadrivalent (HPV4) vaccine and a bivalent (HPV2) vaccine. These vaccines are recommended for girls/women 13-26 years of age in India, although some experts say it can be given up to the age of 45. It protects significantly from the risk of cancer of the uterine cervix, which is women of the most common cancers in Indian women and often is diagnosed in late-stage

Measles Mumps and Rubella (MMR)

MMR vaccines are advised to all adults in India. Two doses of MMR vaccine should be administered at least 4 weeks after the first dose. It is especially important for women planning to conceive, to avoid the risk of rubella infection during pregnancy.

Varicella Vaccine

Varicella or chickenpox vaccine should be administered to all adults who don’t have evidence of immunity to varicella, meaning those who have not had chickenpox in their childhood. 2 doses of single-antigen varicella vaccine should be administered to those who have never been vaccinated against this disease. A minimum gap of 4 weeks should be considered between the two doses.

Typhoid vaccine

Typhoid conjugate vaccines now available can give protection for a much longer duration than the earlier oral typhoid vaccine, which protected for 3 years and had to be taken again after that period. Since typhoid is a disease spreading by water and food contamination, all though who consume outside food, especially in unhygienic conditions, should consider getting the vaccine.

Vaccines for recommended for people with high risk

Hepatitis B (Hep B) Vaccine

Hepatitis B (Hep B) Vaccine is not advised to all adults in India, but to people with percutaneous or mucosal exposure to blood and individuals who are engaged in sexual relationships with more than one person. It is also recommended for health professionals and people who can have accidental exposure to blood such as people getting shaving done outside etc.

India has a big Hepatitis B burden and the disease is highly contagious and often progresses silently till liver damage is severe. Hence if there is any kind of high factor associated, adults should have a discussion with their doctors regarding this vaccine.

Combined Hepatitis A and B vaccines are also available, which offer additional protection to Hepatitis A, which is the commonest viral hepatitis.

Influenza vaccine

The flu vaccine is indicated for people at increased risk of severe flu such as elderly people, young children, pregnant ladies, people with lung disease etc. These people should have a discussion with their doctor about the need for the vaccine

Pneumococcal Vaccine

Pneumococcal Vaccine is classified into types. One is a conjugate vaccine that contains 13 serotypes and the other is a polysaccharide vaccine that contains 23 serotypes. In adults with certain comorbidities, such as diabetes, COPD etc. the combination of these two vaccines serially is recommended.

Meningococcal vaccine

Meningococcal vaccine is recommended to people suffering from functional or anatomic asplenia, or complement component deficiencies. It is also recommended to first-year college students living in dormitories, military recruits, microbiologists who are routinely exposed to isolates of Neisseria meningitides, laboratory workers and people who are in close contacts of the cases. CDC also marks the importance of the meningococcal vaccine for the travellers to Mecca during the annual Hajj. The vaccine should also be administered to the travellers to and residents in sub-Saharan Africa.

Wrapping it up

Although both the American CDC and Indian experts have mandated a number of vaccines for adult, due to lack of awareness people still don’t know that they can have vaccines even for the most common diseases such as typhoid, chickenpox and hepatitis A. Even if they know about these vaccines, they don’t pay much heed to their importance. This is probably due to economic constraints. To ensure a healthy society government should take necessary steps to ensure that all adults are vaccinated against major vaccine-preventable diseases.

Dr. Binita Priyambada

Guest Author Dr. Binita Priyambada is a Senior Medical Consultant at Docprime.com.