LIFE-COURSE PREVENTION. Immunisation addresses different needs and risks at different ages | Photo Credit: lakshmiprasad S

In the last two months, at least three vaccines for adults have been in the news, in addition to one high-profile campaign to vaccinate 14-year-old girls.

For a country that has run childhood immunisation programmes for decades now, this signals the intent of the Centre and some states’ to extend vaccination campaigns beyond infants, to young people and adults. And the government and private sector are driving conversations on vaccines as a preventive against strains of the human papillomavirus (HPV) that cause cervical cancer; pneumonia/ flu; and shingles, caused by reactivation of the varicella-zoster virus that causes chicken pox.

Late February, the HPV vaccination campaign covering 14-year-old girls was launched by Prime Minister Narendra Modi. Days before this, the Centre launched a tetanus and adult diphtheria (Td) vaccine made for the first time in a government set-up — the Central Research Institute in Kasauli, Himachal Pradesh. In the private market, drugmaker GlaxoSmithKline sought to raise awareness on shingles. Its vaccine for those over 50 years is close to clocking three years in India.

Earlier this year, Kerala marked a first of sorts in budgeting for a pneumococcal vaccination programme for older people. At present, India does not run campaigns to vaccinate its elderly against pneumonia and flu, unlike Western countries that have an annual flu vaccine.

The Covid-19 pandemic was possibly the only time the Centre had taken intensive steps to vaccinate young people and adults. The experience, though, resulted in fault lines appearing between those who campaign for vaccination as an effective preventive step and those who campaign to keep the exercise optional.

Across ages

Dr Soumya Swaminathan, former Chief Scientist with the World Health Organization, explains, “You have to look at immunisation as a life-course prevention activity… it’s not only for children, but also all ages and stages of life — there are different needs and different risks at different ages.”

The tetanus and diphtheria vaccines are for adults, once in 10 years to maintain immunity, says Swaminathan, Chairperson, MS Swaminathan Research Foundation. Vaccines for older people include the annual influenza vaccine, Covid booster recommended in many countries (not India), the pneumococcal vaccine (against pneumonia), says Swaminathan.

“We are at a point in the country’s immunisation history where they are shifting not just from looking at children but young adults and elderly as well,” she observes.

But there is a need for research and development to make multi-antigen (combination) vaccines to avoid taking four or five different ones, she says. India has a population that’s slowly ageing and “we’ve got to think about healthy ageing”, she adds.

Not only are the elderly prone to infection, flu/ pneumococcal and shingles, but data also shows that certain chronic diseases arrive in India about 10 years earlier than in Western countries, says Dr Shalini Menon, Executive Vice President (Medical Affairs), GSK India. Stressing the need for an ecosystem to administer adult vaccinations, including addressing apprehensions, she says people need to take informed decisions on their own.

A worried G Venugopalan, who lost his 20-year-old daughter allegedly due to an adverse event linked to the Covid vaccine, questions the need for the adult vaccination campaigns. Pointing to the HPV campaign, he calls for “full disclosure and informed consent” in all public health measures. People are on their own when something goes wrong, he had posted online, urging everyone to discuss and fully understand the safety and efficacy of these vaccines.

‘Pin cushions’

On whether the elderly are now becoming “pin cushions” (with multiple vaccinations), Swaminathan says every available vaccine cannot be introduced in State-run programmes. There is a decision-making process; it’s not arbitrary, she says, adding that it’s “a very scientific process”, where data is examined in terms of epidemiology burden, vaccine effectiveness, safety profile, and so on.

. A vaccine is introduced (by the government) only when all these parameters are met and “green-lighted by the National Technical Advisory Group on Immunization (NTAGI)”, she explains.

Adverse events

Swaminathan explains that “we can’t deny that vaccines would have side effects. Majority of them are mild”. There is a pharmaco-vigilance programme to investigate and establish adverse event links to the vaccines, she says, calling for a transparent approach to acknowledge and compensate the affected. Putting out data helps people understand the rarity of such incidents, she adds.

As vaccination campaigns break new ground, questions continue to be asked in different quarters on adverse events, choice of vaccine, role of local vaccine-makers and cost. Questions that health administrators will need to address to dispel doubt and fear.

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Published on March 9, 2026