NEW DELHI: Despite vaccines being available to prevent several infections that can be particularly serious for older people, adult immunisation remains low in India. Influenza, pneumococcal disease and shingles are among the key vaccine-preventable illnesses that pose a risk to older people, but studies point to poor awareness and low uptake of these vaccines. Ahead of World Immunisation Day Tuesday (Nov 10), the findings highlight a significant gap in protection beyond childhood.
A multicentre study of 4,998 people aged 60 and above across Chennai, Ballabgarh, Kolkata and Pune found only 1.4% had ever received an influenza vaccine. While just 19.7% had heard of influenza, 35.9% considered vaccines safe and 65.3% were unwilling to pay for vaccination. However, uptake rose to 29.7% when vaccines were offered free of cost at community health camps.
Published in ‘BMC Public Health’ in 2026, the study highlights gaps in awareness, acceptance and access to vaccination among older people.
The disease burden is substantial. A separate study published in ‘Influenza and Other Respiratory Viruses’ in April 2026 estimated that influenza among Indians aged 60 and above accounted for 5.3 million respiratory infections, 36,149 hospitalisations and 84,613 deaths in 2021. The researchers found that an annual influenza vaccination programme for older adults could be cost-effective under most of the scenarios assessed.
“Influenza and pneumococcal infections cause a significant burden among older Indians, accounting for an estimated 1.2 lakh deaths annually. Studies show that influenza vaccination can reduce influenza-associated pneumonia cases by 52% and deaths by 70%, while pneumococcal vaccination can lower hospitalisations by around 27% and deaths by 34%. Yet vaccination coverage among the elderly remains very low,” said Dr Neetu Jain, senior consultant, pulmonology, critical care and sleep medicine, PSRI Hospital.
“Annual flu and pneumococcal vaccination is particularly important for people above 60 and those with COPD, asthma, diabetes or heart disease, as infections can lead to serious complications, including respiratory failure and prolonged hospitalisation,” she said.
Evidence is also emerging of the economic value of pneumococcal vaccination. A study published in ‘Infectious Diseases and Therapy’ in Oct 2026 examined the cost-effectiveness of a single dose of the 20-valent pneumococcal conjugate vaccine (PCV20) for older adults and people at higher risk. It found that the vaccine could be a cost-effective option compared with existing vaccination approaches.
Another infection of concern among older adults is shingles, caused by reactivation of the virus responsible for chicken pox. It can lead to prolonged nerve pain, known as post-herpetic neuralgia. A 2026 paper in ‘Indian Journal of Community Medicine’ noted the lack of robust population-based data on shingles in India, while citing an estimate of around 45 lakh cases annually. An Indian phase-3 trial of the recombinant zoster vaccine, published in ‘Vaccine’ in 2025, reported an immune response in 85.7% of participants aged 50 and above.
“Influenza and pneumococcal vaccines can reduce cases of severe illness, hospitalisation and complications, particularly among older people and those with chronic conditions such as diabetes, heart disease and COPD. Both are non-live vaccines and can be given to elderly people, including those with multiple conditions,” said Dr Jatin Ahuja, infectious disease specialist, Apollo Hospitals, Delhi.
“India also needs to expand adult vaccination to cover shingles. The two-dose recombinant zoster vaccine is recommended for adults aged 50 and above and offers over 90% protection. Tdap or Td boosters, hepatitis B and, where indicated, Covid-19 and RSV vaccines should also be considered,” he said.
Goa has taken a step towards expanding vaccination beyond childhood through its Life-course Immunisation Policy 2026-2036, launched in Sept. The policy identifies influenza, pneumococcal and hepatitis B vaccination among its priorities for elderly, those with chronic illnesses, immunocompromised individuals and healthcare workers.
