Vaccines for Adults: What Indian Adults Actually Need
Childhood immunisation in India is well established. Adult immunisation is not, and most adults have no idea which vaccines they are due. Several of them prevent illnesses that kill or disable thousands of adults every year.
Vaccines relevant to most adults
Tetanus and diphtheria
A booster every ten years. Also given after a dirty or deep wound if the last dose was more than five years ago. Tetanus remains present in soil across India and is frequently fatal once established.
Influenza
Annual vaccination, ideally before the season. Particularly recommended for:
- Adults over 65
- Pregnant women, at any stage, which also protects the newborn
- Chronic heart, lung, liver or kidney disease
- Diabetes
- Immunosuppression
- Healthcare workers
Influenza is not a bad cold; it causes a substantial number of hospitalisations and deaths each year, and it also triggers heart attacks in vulnerable people.
Hepatitis B
A three-dose course for anyone not previously vaccinated. Especially important for healthcare workers, people with diabetes, those on dialysis, people with multiple partners, and household contacts of carriers. Hepatitis B is a leading cause of liver cirrhosis and liver cancer in India, and the vaccine is one of the first cancer-preventing vaccines ever developed.
HPV
Recommended for adolescents of both sexes, ideally before sexual activity begins, and licensed up to age 45 for women. It prevents the great majority of cervical cancers, which remain one of the commonest cancers among Indian women, as well as some other cancers. Vaccination does not replace cervical screening.
Pneumococcal
Recommended for adults over 65, and for younger adults with chronic heart, lung, liver or kidney disease, diabetes, immunosuppression, or without a functioning spleen. It prevents pneumonia, bloodstream infection and meningitis.
COVID-19
Boosters as recommended for age and risk group, following current national guidance.
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For specific situations
- Typhoid: useful in high-incidence areas and before travel within India to areas with poor water safety
- Hepatitis A: for those not previously exposed, and for people with chronic liver disease
- Rabies: pre-exposure for high-risk occupations; post-exposure treatment after any animal bite or scratch is urgent and non-negotiable
- Varicella: for adults with no history of chickenpox, particularly women planning pregnancy
- MMR: for adults without documented immunity, and important before pregnancy since rubella in pregnancy causes serious birth defects
- Meningococcal: for Hajj travel, some other travel, and people without a spleen
- Shingles: recommended for older adults where available; shingles is common after 50 and its nerve pain can persist for months or years
- Japanese encephalitis: in endemic districts
Before pregnancy and during it
- Before: rubella immunity checked and MMR given if needed, since MMR cannot be given during pregnancy; varicella if not immune
- During: tetanus-containing vaccine as per national schedule, influenza at any stage, and Tdap where recommended to protect the newborn from whooping cough
- Live vaccines are avoided in pregnancy
For people with specific conditions
- Diabetes: influenza, pneumococcal, hepatitis B
- Chronic kidney disease or dialysis: influenza, pneumococcal, hepatitis B at higher dose
- Chronic liver disease: hepatitis A and B, influenza, pneumococcal
- No spleen or non-functioning spleen: pneumococcal, meningococcal, Hib, influenza — this group is at very high risk
- On immunosuppressive treatment: live vaccines are generally avoided; timing relative to treatment matters and needs specialist advice
Practical points
- Keep a record. Most adults cannot recall what they have had, and this alone causes missed and duplicated doses.
- Mild soreness, low-grade fever and tiredness for a day or two are expected and are not reasons to avoid future doses
- A previous severe allergic reaction to a vaccine component is a genuine contraindication and should be discussed
- Vaccines are not interchangeable across all brands for multi-dose courses; complete a course as advised
When to speak to a doctor
- Before travel, ideally four to six weeks ahead
- After any animal bite or scratch, the same day
- After a wound if tetanus status is unknown
- Before pregnancy
- On starting immunosuppressive treatment
- If you have a chronic condition and have never discussed vaccination
This article is general health information. Vaccination schedules vary by age, health status and local guidance, and should be confirmed with your doctor.