Association of Physicians of India launches first-ever Adult Immunisation Recommendations for India

Outlines evidence-based information on vaccine administration and prevention guidance for various vaccine-preventable diseases

The Association of Physicians of India (API) has released the first ever adult immunisation recommendations for India, in partnership with Abbott. This comprehensive set of recommendations, put forward by a panel of healthcare experts, provides robust, evidence-based information to support physicians in recommending adult vaccination against typhoid, influenza and a range of other diseases. These recommendations meet an urgent need to equip physicians with data on vaccines, including dosage, indications, delivery frequency and administration, so physicians can drive greater coverage of adult vaccination across India.

As per a release, vaccine-preventable diseases (VPDs) in India such as influenza, Hepatitis A and B, typhoid fever and more have undergone a discernible shift in the nature of prevalence, affected age groups and the susceptibility of infectious diseases.[1] Influenza, for instance, is a highly prevalent respiratory disease and seasonal influenza cases in Delhi have significantly increased from 78 in 2012 to 3,627 in 2019.[2] Similarly, in 2016, India reported 6.6 million typhoid cases (499 cases per 1,00,000 population), with 44% of mortality occurring in persons more than 15 years of age.[3] In Delhi, there were 27,132 cases in 2018, contributing 1.18 per cent to India’s total burden.[4]

Factors such as rapid globalisation and increased frequency of international travel contribute to the rising likelihood of adults contracting VPDs.[5] These diseases can also exacerbate existing comorbidities and are associated with high morbidity and mortality[6].

While vaccinations remain the most effective prevention strategy to maintain immunity for a prolonged period, [7] adult immunisation remains neglected. Inadequate awareness, lack of an established body of official recommendations[8] and vaccine hesitancy contribute to reduced vaccine coverage across the Indian adult population.

The adult immunisation recommendations introduced by the API will enable healthcare practitioners to effectively make informed decisions regarding adult vaccines.[9] They explain the role of vaccines as a crucial preventive strategy and health management tool for adults. They encompass information on the causes, symptoms and associated complications of VPDs, including influenza, typhoid, Japanese encephalitis and hepatitis A & B amongst other diseases, and provide clinical data on various available adult vaccines. This data includes indications, dosage, frequency, schedules and catch-up vaccination timelines. The recommendations also highlight the increased need for vaccines amongst specific at-risk populations, including people with comorbidities, healthcare providers, frequent travellers, geriatrics and pregnant women.

Commenting on the recommendations, Padma Bhushan Prof Nirmal Kumar Ganguly, Former Director General, Indian Council of Medical Research (ICMR), New Delhi, stated, “There is potential to increase adult immunisation coverage in India. To develop these evidence-based recommendations, we convened a panel of healthcare experts across specialty practices, ranging from Cardiology, Pulmonology, Gynaecology to Nephrology. The result is a comprehensive body of knowledge outlining best practices and reliable information on adult immunisation in India. Through these  recommendations, we hope to drive a paradigm shift to ensure adult vaccinations are increasingly suggested and adopted.”

Highlighting the role the recommendations can play in improving health outcomes, Dr Srirupa Das, Medical Director, Abbott India said, “While vaccinations prevent infectious diseases, prolong and improve quality of life, emphasis on adult immunisation is pretty low. These recommendations will help increase the awareness and equip healthcare practitioners with evidence-based information to guide vaccine recommendation and administration. At Abbott, we aim to continue raising awareness to protect people from vaccine-preventable diseases, so they can live fuller and healthier lives.”

References:

[1] Rathi, A. (2017). Infectious diseases diagnosis & treatment. Vaccine preventable diseases in Indian adults- burden and prevention. Gavin Publishers.

[2] Seasonal Influenza H1N1: State/UT – wise, Year-wise number of cases and deaths from 2016-2020 & State/UT – wise, Year-wise number of cases and deaths from 2010-2015; available at https://ncdc.gov.in/index4.php?lang=1&level=0&linkid=119&lid=276, accessed on 23 March 2021

[3] Vashishtha VM. Adolescent Immunization Schedule: Need for a Relook [Internet]. Vol. 101, INDIAN PEDIATRICS. 2019 [cited 2019 Jul 17]. Available from: https://www.indianpediatrics.net/feb2019/101.pdf

[4] National Health Profile (NHP) of India- 2019

[5] Rathi, A., & Sharma, S. (2017). Vaccine Preventable Diseases in Indian Adults- Burden & Prevention. Infect Dis Diag Treat, Gavin Publishers. 2017(1), J102.

[6] Association of Physicians of India (2020). Adult Immunization in India: Changing the Immunization Paradigm. Wiley India Publications.

[7] Rathi, A. (2017). Infectious diseases diagnosis & treatment. Vaccine preventable diseases in Indian adults- burden and prevention. Gavin Publishers.

[8] Rathi, A. (2017). Infectious diseases diagnosis & treatment. Vaccine preventable diseases in Indian adults- burden and prevention. Gavin Publishers.

[9] Association of Physicians of India (2020). Adult Immunization in India: Changing the Immunization Paradigm. Wiley India Publications.