Dr Pullela Srikar Krishna, MD-General Medicine, Consultant, Apollo Clinic highlights that the development and deployment of COVID-19 vaccines have underscored the importance of vaccinating adults to control the spread of infectious diseases and protect individual and community health
The emphasis on childhood vaccinations stemmed from the fact that many vaccine-preventable diseases posed a higher risk to children, who were more susceptible and vulnerable to severe complications. Additionally, targeting children for immunisation provided an opportunity to establish herd immunity, protecting the broader population. However, as our understanding of infectious diseases and the role of vaccines has evolved, the significance of adult vaccinations has become increasingly apparent. Vaccine-preventable diseases can indeed have substantial impacts on adult mortality, health, and overall quality of life. Many infectious diseases, such as influenza, pneumonia, and hepatitis, can affect individuals of all ages, including adults. These diseases can lead to severe illness, hospitalization, long-term complications, and even death.
Despite the evident benefits of adult vaccinations, they were historically overlooked as health priorities, primarily due to several factors. Firstly, the perception that vaccines were primarily for children and the belief that adults had already developed immunity through prior exposure to infectious diseases contributed to the oversight. Additionally, limited awareness and understanding of the importance of adult immunisation among both healthcare providers and the general public played a role.
How the COVID vaccination drive highlighted its importance
The COVID-19 pandemic has brought adult vaccination to the forefront of public health priorities. The development and deployment of COVID-19 vaccines have underscored the importance of vaccinating adults to control the spread of infectious diseases and protect individual and community health. It has also served as a catalyst for raising awareness about the importance of other adult vaccinations. In many cases, adults receiving the COVID-19 vaccine have been encouraged to review their immunisation status and catch up on other recommended vaccines, such as influenza, pneumonia, and other preventable diseases.
Additionally, the COVID-19 pandemic has demonstrated the value of adult vaccination in preventing the overwhelming burden on healthcare systems. By reducing the number of severe COVID-19 cases and hospitalisations through vaccination, healthcare resources can be better allocated to other medical needs, leading to improved overall healthcare outcomes. The experiences and lessons learned during this pandemic can help shape future immunisation strategies, emphasising the importance of comprehensive adult vaccination programs that encompass a broad range of preventable diseases beyond COVID-19.
Vaccinations that happen in adult life
Pregnancy presents a prime opportunity for healthcare workers to promote preventive health strategies amongst pregnant women as well as their family members. Women are more likely to follow advice regarding vaccination during pregnancy and also to adhere to the schedule. Vaccinating pregnant women has the added advantage of passing on immunity to the unborn child.
Tetanus is a deadly infection that can be prevented with vaccination. Two tetanus toxoid (TT) injections, 4 weeks apart should be given to all pregnant women for whom the prior vaccination status is unknown. The other alternative is the 3-in-1 vaccine called TDaP which provides protection against Tetanus, Diphtheria and Pertussis, especially in the baby during the first 6 months after birth when they are most vulnerable.
Influenza infections can be more complicated with an increased risk of hospital admissions in pregnant women. Hence, all pregnant women should routinely receive the inactivated influenza vaccine if they are likely to be pregnant during the flu season.
COVID-19 vaccines are also approved for use in pregnant or lactating women after the risks and benefits have been explained to them. Other vaccines which can be considered in pregnancy are Hepatitis B and Hepatitis A vaccines, only in those who are at high risk of these infections.
Vaccination in adult women:
HPV vaccination should be given preferably to girls from 9-14 years of age. Catch up vaccination with 3 doses can be given to women aged 15-26 years and can also be considered upto 45 years, with the awareness that efficacy will be reduced and that they should follow up regularly for cervical cancer screening tests.
Other vaccinations adults need to be aware of
In addition to COVID-19 vaccination, there are several other vaccinations that adults should be aware of to protect their health. The specific vaccines recommended for adults may vary based on factors such as age, underlying health conditions, occupation, travel plans, and lifestyle. Here are some of the important vaccines that adults should consider:
Influenza (Flu) vaccine: Influenza can cause severe illness and even death, particularly in older adults and those with chronic health conditions. The flu vaccine is recommended annually for all adults to protect against circulating strains of the influenza virus.
Pneumococcal vaccine: Pneumococcal disease can lead to serious infections such as pneumonia, meningitis, and bloodstream infections. The pneumococcal vaccine is recommended for adults, particularly those over 65 years of age and individuals with certain chronic conditions.
Tdap/Td vaccine: Tdap vaccine protects against tetanus, diphtheria, and pertussis (whooping cough). Adults who have not received a Tdap vaccine should get one dose, followed by a Td (tetanus and diphtheria) booster every 10 years.
Shingles (Herpes Zoster) vaccine: Shingles is a painful rash caused by the reactivation of the varicella-zoster virus. Vaccination is recommended for adults aged 50 years and older to prevent shingles and its complications.
Hepatitis A and B vaccines: Hepatitis A and B are viral infections that affect the liver. Hepatitis A vaccine is recommended for individuals at higher risk, such as travelers to certain countries and those with chronic liver disease. Hepatitis B vaccine is recommended for adults at risk due to certain occupations, healthcare exposure, or specific medical conditions.
Human Papillomavirus (HPV) vaccine: HPV is a sexually transmitted infection that can lead to various cancers, including cervical, anal, and oropharyngeal cancers. HPV vaccination is recommended for both males and females up to the age of 26, and up to the age of 45 in certain circumstances.
Meningococcal vaccine: Meningococcal disease is a bacterial infection that can cause meningitis and bloodstream infections. Vaccination against meningococcal disease is recommended for individuals with certain risk factors, such as college students living in dormitories, military recruits, and individuals with certain immune deficiencies.
It is essential for adults to consult their healthcare providers to assess their individual vaccination needs based on their medical history, lifestyle, and any specific recommendations for their age group or geographical location. Vaccines not only protect individuals but also contribute to community immunity by reducing the spread of infectious diseases.