Medically reviewed by Dr.(Lt Gen) R.K.Suri retd.

We always thought vaccination was for babies and not adults, but the pandemic changed everything, didn’t it? The deadliness of the Covid-19 virus taught us bitter lessons about how easily infections can spread and enter our bodies without our being aware of it. Whilst we have been anxiously watching the development of corona vaccine, we have forgotten about the ones which have already been developed with years of hard work by scientists. Are we taking the full benefit? Probably not. 

An effort at all levels is required to give the required push to adult vaccination for promoting growth, both on the health and economic front.

There is a categorical adult immunization protocol recommended by the World Health Organization ( WHO) for all countries. It is time we raised our awareness about infectious and preventable diseases. 

Why is Adult vaccination necessary? 

Here’s why:

• Many of the vaccinations adults received as a kid have to be repeated to maintain immunity. 
• Life-threatening illnesses are dangerous for seniors because their immune system (disease-fighting mechanism) becomes weak due to age or health conditions. 
• Many adults work as health workers, teachers or in professions that expose them to deadly infections.  
• They may have missed some vaccination as a kid
• Some vaccines were not even available when they were young!

And contrary to belief, seemingly harmless diseases like the flu can cause serious damage as well. 

In this feature, we will learn about a few of the preventable life-threatening diseases, their schedules and your eligibility for them.

Let us see some prominent vaccine schedules for adults, their doses, and your eligibility to receive them.  

The Most Important Vaccines Adults Need 

Influenza- The Flu Vaccine

The very common recurrent H1N1 seasonal flu or influenza(including swine flu) affects millions of adults worldwide. The disease is a result of a virus infection. Some people can recover in a few days. Nonetheless, influenza kills many people across the globe. In the current consequence of the corona pandemic, protection from the flu has become significant. Patients have caught both the flu and coronavirus leading to serious complications. Even influenza alone, with its respiratory predicaments, can prove fatal for many. It is highly contagious, and no matter how many precautions you take, your coworkers or friends may expose you to the virus.  The influenza vaccine provides vital protection. Two separate types of vaccines have been made for the northern hemisphere and the southern hemisphere( that includes India).

 Who should get a flu vaccination?

In most countries the influenza vaccine is mandatory. But now medical associations( especially pediatric), are stressing the need to make it essential in India as well.

With a few exceptions, all adults should take a yearly influenza shot:

1. 60 years & above- must take standard or high dose IIV 

1. Healthy persons between 18 and 64 years-  to protect themselves & the immunocompromised persons they come in contact with. 
2. Pregnant women – run the risk of miscarriage if they catch the flu during pregnancy 
3. Health care professionals- as they take care of immunocompromised patients should take IIV dose
4. Healthy persons up to 49 years can get intranasally administered live attenuated influenza vaccine (LAIV)

Who should not get

Those with an allergy to eggs, Guillain-Barre Syndrome or a current sickness shouldn’t take the flu shot.

Booster dose

The influenza vaccine is effective for a year. You must take a single shot every year before the flu season. 

TDAP – Tetanus, Diphtheria, Pertussis

TDAP is a single dose vaccine combo for protection against Tetanus, Diphtheria and Pertussis ( whooping cough). Tetanus is a life-threatening infection that enters through deep wounds and attacks the brain and ikonervous system to cause severe muscular spasms in the whole body. Diphtheria is a contagious disease that attacks the respiratory system and advances to the heart and nerves. Pertussis is a respiratory disease too, highly contagious and dangerous, specifically for infants.

Td is the booster dose of TDAP for adults.

Who should get Td? 

•  Adults 29 or older who have never taken it, have an unknown or incomplete history of doses( less than 3)
• People who take care of infants, including nannies.
• Pregnant women in their third trimester should get 2 doses of tetanus toxoid in every pregnancy(TT2) to safeguard themselves and the newborn against tetanus.
• Healthcare workers who tend to patients.
• A person who has a deep cut or burn and hasn’t been vaccinated before.

Who needs a booster dose?

Primary Tdap is administered once in life, however, the boosters are required every ten years. Those adults who received the shot more than ten years ago can take the booster shot.

Who should not get? 

As an adult, you should consult your doctor about your eligibility to get Td dose if

• You have epilepsy or a nervous system disorder
• You had a severe reaction after taking the same vaccination in the past 
• You have a serious illness ( not a mild cold or fever)

Pneumococcal Vaccine

Pneumococcal disease is a bacterial infection that can cause many types of illness, including pneumonia, blood disorders, and meningitis. Its complications can be life-threatening, especially for senior citizens. The infection enters the body through the saliva or mucous of an infected person. Pneumonia affects the air sacs of the lungs, making them fill with fluid or pus. Meningitis is a deadly disease of the brain and spinal cord.

It is important to note that Pneumonia is also a serious complication of corona that inflicts breathing problems and puts you in hospital.

The disease can be mild, however, it can prove fatal as well. That is why immunization is very important. 

There are 2 types of vaccines

1. Prevnar 13 conjugate  
2. PPSV23  conjugate covers 23 stereotypes.

Dosage: Everyone should get two shots to protect them. First, the Prevnar 13 shot should be given. It should be followed by PPSV23 a year later. It will cover you for lifetime.

Booster Shot: The above-mentioned dose provides lifetime protection. However, based on your specific health situation you may discuss the utility of booster shot every 5 years with your doctor.

The Serum Institute of India ( SII) has recently launched a new variant called  Pneumosil.

Who should get the Pneumococcal vaccine?

Seniors citizens and older adults have an inflated risk of life-threatening situations from this disease. Those who must immunize themselves are:

• Adults above 65 – because immunity decreases with age
• Those with a weak immune system – diseases such as diabetes, heart, cancer and asthma etc compromise your immunity
• Smokers– for those who have been smoking a long time, lungs are susceptible to attack
• Adults who consume alcohol regularly have less protection due to poor WBC and weak lungs.

You may note that the WHO recommends that children and infants in every country be immunized against pneumonia.

Who should not get it?

Doctors do not advise Pregnant ladies to get this vaccine, just to be on the safe side. A healthy person between 18 and 50 may also skip it presently.

Hepatitis B

Hepatitis B is a serious liver disease caused by viral infection. Chronic hepatitis B causes cirrhosis, liver failure, liver cancer and other chronic diseases too. 75% of patients are unaware that they are infected and transmit the disease through body fluids, shared needles or sexual intercourse. The disease is highly contagious, as the hepatitis virus can also travel through food, water, objects and contact with an infected person. In severe cases, it can become fatal. Common symptoms include fatigue, low appetite, nausea, and jaundice.

Early-detected mild cases may not cause much damage but chronic cases become difficult to cure and may lead to liver failure.

Dosage: There are many vaccines available. The Hepatitis A and Hepatitis B combination vaccine is most convenient and provides long term immunization from both.  It consists of three shots, at 0, 1st and 6th month. 

Who should get it?

All adults who have never been immunized and want protection from hepatitis should take the doses. The combination vaccine can be administered to persons 18 years of age and above. All persons who are at a higher risk of the disease should get vaccinated. It includes spouses of infected people, health workers, people who take illicit drugs, have chronic liver disease, or travel to countries having endemicity of hepatitis. 

Cervical Cancer- HPV Vaccine

In women, the cancer of the cervix is the second most common cancer in women worldwide after breast cancer. Cervix is the small fleshy plug between the uterus and the vagina. The disease is caused by a viral infection by the human papillomavirus. Unless the virus is detected in the pre-cancer stage, it is difficult to cure and can spread to other parts of the body too. However, it is entirely preventable with the HPV vaccine. WHO recommends that the Human Papillomavirus Vaccine be ideally given to all females in their reproductive age.

Symptoms of cervical cancer include pain in the pelvis & during intercourse as well as bleeding after intercourse, menopause or in between periods. 

Dosage: Three doses at zero month, 6 months, and 12 months. 

Who should get

All girls should take the immunization from puberty till menopause ( ideally till 26 years of age). For older women, regular screening every year is required with a Pap smear test to detect the HPV virus.   Note that the human Papillomavirus spreads through sexual contact, so males who have homosexual relationships are also required to take immunization against this virus( though not for cervical cancer).

Who should not get?

Pregnant women and persons who are severely ill.  

Booster shots

HPV immunization is effective for lifetime. Generally, a booster dose is not required.

The Takeaway

Decades of research has been invested by the medical fraternity in the development of vaccines. It is always best to get a shot even when you think your risk of infection is low. When each and every person gets a jab, vaccine-preventable diseases can be totally eradicated. Be vigilant and take part in the adult immunization programme to protect yourself, your loved ones and the broader community from life-threatening illnesses. Speak to your doctor today.