Adult immunisation remains limited in India despite the availability of vaccines against infections that can cause serious complications among older people. Influenza, pneumococcal disease and shingles are among the key vaccine-preventable illnesses affecting this population. Findings from recent studies point to persistent gaps in awareness, acceptance and access to vaccination, highlighting the need to strengthen protection beyond childhood.
A multicentre study involving 4,998 people aged 60 and above across Chennai, Ballabgarh, Kolkata and Pune found that only 1.4% had ever received an influenza vaccine. Just 19.7% of participants had heard of influenza, while 35.9% considered vaccines safe and 65.3% were unwilling to pay for vaccination. However, uptake increased to 29.7% when vaccines were provided free of cost at community health camps. Published in BMC Public Health in 2026, the study highlights the barriers limiting adult vaccination among India’s elderly population.
The disease burden remains substantial. A separate study published in Influenza and Other Respiratory Viruses in April 2026 estimated that influenza among Indians aged 60 and above caused 5.3 million respiratory infections, 36,149 hospitalisations and 84,613 deaths in 2021. Researchers also found that an annual influenza vaccination programme for older adults could be cost-effective under most of the scenarios evaluated.
Dr Neetu Jain, Senior Consultant, Pulmonology, Critical Care and Sleep Medicine, PSRI Hospital, said: “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,”
She added: “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,”
The economic case for pneumococcal vaccination is also gaining attention. A study published in Infectious Diseases and Therapy in October 2026 assessed 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 alternative compared with existing vaccination approaches.
Shingles, caused by the reactivation of the virus responsible for chickenpox, is another concern for older adults. The infection can lead to prolonged nerve pain, known as post-herpetic neuralgia. A 2026 paper in the Indian Journal of Community Medicine highlighted the lack of robust population-based data on shingles in India, while citing an estimated 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.
Dr Jatin Ahuja, Infectious Disease Specialist, Apollo Hospitals, Delhi, said: “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,”
He further said: “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.”
At the policy level, Goa has introduced its Life-course Immunisation Policy 2026–2036, launched in September 2026, to extend vaccination efforts beyond childhood. The policy identifies influenza, pneumococcal, and hepatitis B vaccination as priorities for older adults, people with chronic illnesses, immunocompromised individuals, and healthcare workers.