![](https://www.nextias.com/ca/wp-content/uploads/2023/07/817613Screenshot.png)
In News
- The COVID-19 vaccination drive is a reminder that the benefits of many vaccines have yet to reach the adult population.
Challenges of Adult Immunisation
- Perception of Child Oriented Thing
- Before the COVID-19 pandemic, most people linked and associated vaccination with children only.
- Maximum benefits when administered early
- Scientifically, the benefit of most vaccines are greater if administered earlier in life ( during infancy and childhood)
- A reason children are usually prioritised and vaccines recommended for every child.
- For the remaining age groups, vaccines are recommended for specific sub-groups such as
- For older people or those with specific health conditions.
- Scientifically, the benefit of most vaccines are greater if administered earlier in life ( during infancy and childhood)
- Inequities in Vaccine Coverage
- The importance of vaccines, which are considered to be among the most cost-effective public health interventions, has been recognised globally.
- Yet, the full benefits of vaccines do not reach all children and other age groups.
- There are wide inequities in children by geography, gender, parent’s education and family’s socioeconomic status, and other stratifies.
- The coverage of most available vaccines in adults in India is sub-optimal.
- The importance of vaccines, which are considered to be among the most cost-effective public health interventions, has been recognised globally.
History of Vaccination
|
Why is there a need for adult vaccination?
- Outbreaks:
- Japanese Encephalitis (JE) in 2005-06
- India had to conduct mass scale JE vaccination in the endemic districts, which included the adult age group.
- Swine Flu vaccines
- For health workers during the H1N1 (2009) pandemic in 2009-10.
- Other than that, there has been limited focus on the systematic efforts for adult vaccination in India.
- Japanese Encephalitis (JE) in 2005-06
- Low vaccine-preventable diseases (VPDs) burden:
- Review of available data has pointed out that increased childhood vaccination coverage has resulted in
- Proportionately higher cases of VPDs in the older age groups.
- The larger adult population renders a greater social impact in terms of absenteeism from work (due to illnesses) and the associated costs of health care seeking and hospitalisation.
- Decreasing Immunity:
- There is emerging scientific evidence on waning immunity
- Thus there is a need for booster doses in the adult age group for the vaccines administered in childhood.
- An opportunity in hand:
- The COVID 19 vaccination drive has drawn our attention to the possibilities of adult vaccination, which should be used effectively.
- The Immunization Agenda 2030:
- The vaccines which have become available in the last two decades (which adults had not received as children) have the potential to be beneficial.
- There are more deaths due to pneumonia in adults than in children.
- A proportion of illnesses, hospitalisations and deaths in all age groups can be prevented by
- increasing coverage of currently licensed vaccines which prevents pneumonia and related complications.
- These vaccines are already a part of childhood vaccination programmes
- However, the coverage and benefits need to be expanded to the identified high-risk adult population.
- The available evidence has resulted in the global stakeholders agreeing to ‘the Immunization Agenda 2030’
- which has emphasised that countries should consider extending the benefit of vaccines to all age groups.
Reasons for lack of Adult Vaccination
- National vaccine policy of India, 2011
- The first and only policy of India, released in 2011. had no mention of adult vaccination.
- The National Technical Advisory Group on Immunisation (NTAGI) in India
- on a few occasions, discussed adult immunisation but stayed away from any recommendation for the general population except for
- the vaccination of health workers as high-risk groups, for hepatitis B vaccine, etc.
- Low Private Sector participation
- Outside the Government, professional groups such as
- The Association of Physicians of India and the Indian Society of Nephrology have released guidelines on adult vaccination.
- However, as these are voluntary and thus the private sector share in vaccination in India is very small
- Outside the Government, professional groups such as
- Limited Data
- Therefore the impact remains unknown and is likely to be low.
- There is very limited data on the burden of vaccine-preventable diseases (VPDs) in adult age groups in most countries including India.
Steps to be taken
- Expand the mandate of NTAGI:
- It may review available scientific evidence and provide recommendations on adult vaccination in India.
- These recommendations can be regularly revisited and revised once additional data become available.
- An NTAGI subgroup on adult vaccination can also be constituted to facilitate the process.
- Strengthen Vaccine-Preventable Diseases (VPD) Surveillance System:
- The capacity to record, report and analyse data on the disease burden and immunisation coverage need to be enhanced.
- The focus has to be on analysing immunisation coverage and VPD surveillance data by age and other related stratifiers.
- Capacity Building:
- The capacity of research and academic institutions to conduct operational research including
- the cost-benefit analysis and to guide evidence-informed decisions needs to be boosted.
- Such analysis and evidence can be used by NTAGI in decision-making processes.
- The capacity of research and academic institutions to conduct operational research including
- Drafting India’s national adult vaccination policy:
- The process for developing and drafting a road map or the policy and strategy should be initiated.
- Any such policy should factor in the learnings and lessons from the ongoing COVID19 vaccination drive as well.
- Policy questions in need of the answers should be identified now, and the process to generate evidence started.
- Otherwise, there is a risk of asking policy questions 10 years down the line which can be answered in a few years from now.
- The process for developing and drafting a road map or the policy and strategy should be initiated.
- Operational level
- The shortage of life-saving rabies vaccine in India in 2019 is a reminder of the risk and vulnerability in vaccine supply.
- To ensure vaccine security and be future-ready for adult vaccination.
- The existing public sector vaccine manufacturing units in India should be revived and more need to be set up.
- Awareness drive:
- Initiatives should be taken to educate public health care providers and members of professional associations
- about currently available vaccines for adult age groups.
- This can help people to make an informed choice and healthcare providers to share information with citizens.
- Initiatives should be taken to educate public health care providers and members of professional associations
Way Forward / Conclusion
- Benefits of Licensed Vaccines
- In COVID 19 vaccination, it was the government facilities which have delivered 93%- 95% of total vaccine shots.
- The vaccination is a reminder that the benefits of already licensed vaccines are yet to reach the adult population.
- Institutionalise Mechanism
- It is an opportunity for health policymakers in India to institutionalise mechanisms to examine the need for adult vaccination.
- Also to make policy decisions and empower adult citizens to make informed choices on whether they wish to get currently available vaccines.
- Expanding Immunisation
- It is time to plan for and expand the benefits of vaccines, for all age groups as part of the Universal Immunization Programme Plus in India.
- Drafting and developing a national adult vaccination policy
- The strategy could be one such concrete step in the right direction.
- The success of strategizing can be seen in the childhood vaccination programme.
- It is amongst the best performing government health programmes in India.
National Technical Advisory Group on Immunisation (NTAGI)
|
Source: TH
Previous article
Draft Mediation Bill, 2021
Next article
Leonids Meteor Shower