Experts have advocated the need for adult vaccination to tackle the growing incidence of pneumococcal infection in adult diabetic patients, people with chronic kidney disease and HIV infected patients caused by bacteria which gets spread through air. They have recommended a pneumococcal vaccine which is available in the Indian market costing as less as Rs. 1,200. The vaccine can isolate 23 strains of bacterium and offer immunity as high efficacy rate has been reported in patients above 65 years of age.
Though the National Vaccine Policy issued by the Union health ministry has given guidelines to policy makers and programme managers regarding various strategies for strengthening the universal immunisation programme, the health ministry's expert group on immunisation has observed that few published data are available from India regarding efficacy and safety of vaccines in adult immunisation strategies.
Says consulting cardiometabolic specialist Dr Hemant Thacker, “Incidence rises with age and the burden is very large in India. There is 3 to 6 fold increase in pneumococcal disease in diabetics group of population which is more in the winter months. Viral infections also lead to an increase in the pneumococcal infections amongst the diabetics during monsoons.”
He further explains that there is high rate of fatality amongst elderly patients with more than 25 per cent of such cases being fatal. The bacteria leads to serious infections of the lungs called pneumonia – pneumococcal pneumonia and affects the blood and brain – called IPD (Invasive pneumococcal disease). Investigation available currently in India to diagnose the disease are chest X-ray and blood test.
Substantial improvements in adult vaccination are needed to reduce the health consequences of vaccine-preventable diseases. Although adults have less chance of getting infection, the emergence of HIV and re-emergence of disease like malaria and tuberculosis worldwide have complicated prevailing fragile healthcare scenarios. Incomplete and inadequate immunisation in India against these diseases results in costs for hospitalisation and treatment. The adult population has increased vulnerabilities of getting communicable diseases owing to urbanisation, globalisation, and increasing international travel.
The expert group on immunisation also explored that there is paucity of epidemiological reliable data in India regarding the burden of communicable diseases.
Because of scarcity of data on communicable diseases and adequacy of immunisation (e.g., optimal antibody titers in adults for preventing various diseases), expert group realised that there is an urgent need for collecting reliable epidemiological data in India on infectious diseases, efficacy and safety data regarding various adult immunisation strategies, and data regarding the adequacy of immunisation in adults.
This group suggested that the consensus guidelines about adult immunisation should be reviewed every three years to incorporate new strategies from emerging research in India. It also reviewed the available data from India and other countries and extrapolated to conditions in India, keeping in view the cost-effectiveness of adult immunisation in a huge-population country like India with limited resources.
Vaccines are recommended for adults on the basis of age, prior vaccinations, health conditions, lifestyle, occupation, and travel. There have been significant efforts to curb morbidity, mortality and disability among adults particularly due to communicable diseases such as tetanus, diphtheria, pertussis, hepatitis A, hepatitis B, human papilloma virus, japanese encephalitis, measles, mumps, rubella, meningococcus, pneumococcus, typhoid, influenza, and chickenpox. Nevertheless, in a developing country like India, communicable diseases contribute to a large burden morbidity, mortality, and disability.