The Association of Physicians of India has embarked on an exercise to draw up a fresh set of adult immunisation guidelines. The agenda is now to specify what vaccines are important for adults to take, when to take them, and weigh in the risks against benefits.
“Adult vaccination is the most ignored part of heathcare services,” Muruganathan, president, Association of Physicians of India, says. “Many adults, including doctors, think immunisation is only for children. In fact we have many doctors who have asked questions about the need for adult vaccination.”
It is to address these questions that the API drew up a set of guidelines for adult immunisation in 2009. “There have been several changes since then. Newer technologies are available now, in vaccine manufacturing. These sophisticated manufacturing techniques have rendered vaccines more effective, and with fewer and fewer adverse effects after immunisation. This means we have to redraw our guidelines all over again.”
The process is to give each vaccine to experts in the area, and have them draw up a protocol. For example, as far as influenza vaccine goes, the expert will discuss the periodicity and type of vaccine that is to be administered and when it should be done. This is then disseminated throughout the country to other physicians and experts, and a consensus is drawn after a consultation. The entire process might take between four and five months, he says.
“It is only then that we will have a ready reckoner for administering all adult vaccines in the country. This will be sent to the government and non governmental agencies as recommendations,” Dr. Muruganathan explains. No brand names will be recommended, only the generic forms of vaccines will be specified.
He says all adults over 50 years need to maintain protection against conditions such as seasonal influenza (Flu); pneumococcal disease (pneumonia, sepsis, meningitis); Hepatitis B infection (for adults who have diabetes or are at risk for hepatitis B); tetanus, diphtheria and pertussis (for all adults who have not previously received this); and shingles (for adults 60 years and older).
In India, many adults over the age of 50 die from vaccine-preventable diseases such as Hepatitis B and pneumonia. An instance of this can be seen in the increasing hospitalisation for pneumonia amongst the older adults.
Vijay Vishwanathan, chief diabetologist, M V Hospital for Diabetes, and State secretary of the API, informs that a recent study at the hospital indicated that only about five per cent of the diabetes patients were getting vaccinated. Vaccination is also a way to ensure fewer hospitalisations for complications, he adds.
“Actually, all adult vaccines are important, he stresses again. But, it is all the more important for people with immune compromised conditions, diabetes, liver disease, heart disease, respiratory diseases, and those in high risk situations to take the vaccines to get vaccinated,” Dr. Muruganathan says. This includes paramedics, nurses, and doctors and surgeons, who are routinely exposed to a lot of influenza and various other forms of infections, including Hepatitis B.