Adult Immunisation Gap in India’s Elderly Population

India has nearly 130 million people aged 65+, but vaccine coverage for older adults is <5%, compared to 75–90% childhood coverage under Universal Immunisation Programme (UIP).

Elderly Population and Ageing in India: Key Statistics

Elderly Population: 104 million in 2011; projected 319 million (19% of population) by 2050 (UNFPA).
NCD Burden: 70% of elderly deaths due to non-communicable diseases (ICMR).
Mental Health: One in five older adults suffer from depression or anxiety; fewer than 10% receive adequate care, according to NIMHANS.
Disability: 22% of the elderly face disabilities; high dependency on informal care (NIH).
Geriatric Infrastructure: Only 18 Regional Geriatric Centres under NPHCE (2023).

Why Elderly Vaccination Matters?

Immunosenescence Risk: Ageing weakens immunity, so infections last longer and complications become severe, increasing frailty and dependence.
Shingles Threat: Herpes Zoster lifetime risk is ~30%, rising to ~50% by age ≥85, with complications like neuralgia, vision loss, and stroke risk.
Influenza in India: India has two peaks (monsoon + winter), raising year-round exposure risks.
Pneumococcal Fatality: Case fatality rate for invasive pneumococcal infections is 20–25% in ≥65 years, vs ~5–10% in younger adults.

Government Initiatives for Vaccination Drive in India

Universal Immunisation Programme (UIP): Provide free vaccines to all children and pregnant women against major preventable diseases to reduce morbidity and mortality.
Mission Indradhanush: Achieve full immunisation for children under two and pregnant women, especially in underserved areas, targeting key preventable diseases.
Har Ghar Dastak Campaign: Ensure door-to-door COVID-19 vaccination coverage, reaching unvaccinated individuals in rural and remote regions.
U-WIN Portal: Digitally track immunisation, monitor vaccine supply, and ensure timely delivery for efficient program management.
HPV Vaccination Initiative: Prevent cervical cancer by providing free HPV vaccines to girls aged 9–14 under state-supported programs.
Vaccine Maitri Initiative: Support global vaccination and international cooperation by supplying COVID-19 vaccines to neighbouring countries.

Key Barriers in the Vaccination Drive

Cost Burden: Uptake is limited because most adult vaccines are out-of-pocket for seniors, and high-cost vaccines (like shingles) deter demand; coverage remains <5%.
Weak Systems: Low adult vaccine coverage (<5%) reflects weak surveillance, absence of adult registries, limited provider training and lack of public campaigns
Hesitancy Myths: Low uptake is reinforced by misunderstandings like “not 100% effective = useless” and fear of side effects/injections.
Follow-Up Failure: Influenza requires annual vaccination, and adult boosters are needed every 5–10 years, but reminder systems are largely absent.

Way Forward

National Policy: Launch a structured adult immunisation schedule by age/condition integrated into primary care; E.g., ACIP Adult Immunisation Schedule (USA)
Cost Support: Subsidise high-impact vaccines for 65+ through pooled procurement. E.g., deliver via Ayushman Bharat–Health and Wellness Centres (HWCs) under NHM.
Outreach Delivery: Community/home vaccination drives to reduce access barriers; E.g., polling-booth style outreach at senior centres.
Reminder Systems: Use SMS/phone alerts for annual/booster schedules; E.g., CoWIN-like reminder architecture for adult vaccines.

India’s rapid demographic ageing makes adult immunisation a core preventive priority, as WHO notes, “vaccination is a life-course investment.” Embedding life-course immunisation within primary healthcare is essential for healthy ageing and system resilience.

Reference: The Hindu

PMF IAS Pathfinder for Mains – Question 516

Q. In the context of India’s rapid demographic ageing, discuss why vaccine-preventable diseases pose increasing risks to older adults. Suggest institutional and technological interventions to improve adult immunisation coverage. (150 Words) (10 Marks)

Approach

Introduction: Write a contextual introduction by mentioning the recent data.
Body: Write why vaccine-preventable diseases pose increasing risks to older adults, then suggest institutional and technological interventions to improve adult immunisation coverage.
Conclusion: Emphasis on life-course immunisation approach to improve adult immunisation coverage.