Influenza cases and deaths, which began showing a spike in Kerala last month (May 2026), have doubled in the past two weeks.

With many elderly, especially those with various comorbidities, succumbing to influenza, public health experts have demanded that the State invest in the provision of free annual flu vaccines to the elderly, as these can save lives and health-care costs.

This year as of June 13, the State has reported 1,700 cases of influenza, and 19 deaths, with the cases and deaths showing a sharp spike in the past two weeks. Almost all of the deaths have occurred in the elderly.

The elderly, especially those above 70 years, are disproportionately vulnerable to the flu virus and the complications.

Pneumonia

Medical research shows that influenza viral infections serve as the primary gateway to lethal secondary pneumococcal bacterial infections (pneumonia) in older adults. By compromising the respiratory tract’s natural mucosal immunity, the flu virus enables bacteria to easily colonise the lungs and develop into severe, life-threatening pneumonia, which is the leading cause of mortality in patients affected by influenza.

There is robust and consistent evidence from various studies that flu vaccines as well as vaccination against pneumonia in adults (pneumococcal vaccines - PCV ) can offer significant protection to the elderly against death and the complications of the disease caused by influenza A (H1N1) and influenza B.

“The acute systemic stress triggered by influenza frequently precipitates sudden cardiovascular and cerebrovascular events, such as heart attacks and strokes, among the elderly. These preventable medical emergencies devastate household financial stability and result in the inefficient expenditure of substantial public health-care funds on downstream, critical care management,” B. Ekbal, public health activist and former member of the State Planning Board, said.

₹50 crore earmarked

Kerala took a first step towards adult immunisation when it earmarked funds—₹50 crore—in the previous Budget for providing pneumococcal vaccination to those elderly in the BPL category in the State.

Dr. Ekbal has suggested that the government provide a ‘comprehensive respiratory shield’ for the elderly by incorporating the influenza (flu) vaccine, along with the pneumococcal vaccine, in the State’s initiative to provide free vaccination for the elderly.

While the PCV is a one or two dose affair (depending on the vaccine type) for life-time, flu vaccination has to be renewed every year as the virus constantly evolves and evades the immune system, re-infecting people with new mutated strains

Adult immunisation is as critical as the immunisation offered to children. In order to fully realise the clinical objectives and fiscal benefits of providing adult immunisation, it is essential that the State take the effort to integrate the flu vaccine alongside the pneumococcal vaccine, Dr. Ekbal, who led the State Vaccine Policy initiative earlier, said.

Given the demographic and epidemiological transition in the State, wherein the population of the elderly is set to touch 23% in the next decade and a chunk of the adult population already has chronic multimorbidities, Kerala should now be moving towards the lifecourse approach in immunisation as a strategy to protect the elderly and to encourage the healthy ageing of its adult population, it is pointed out.