By Dr. Tadikonda Ambica, Pharm D - Adult Vaccination Officer
In India, discussions about vaccination often stop at childhood. However, adult immunization is crucial for preventing infectious diseases, reducing healthcare costs, and protecting vulnerable populations, yet it remains an overlooked area. Many adults, despite being susceptible to infections and chronic conditions, mistakenly believe that they no longer require vaccines.
Vaccine-preventable illnesses (VPDs) like pneumonia, HPV-associated cancers, influenza, and shingles (to name a few) continue to harm families, healthcare systems, and economies.
However, the global call for strengthened preventive healthcare and the gaps exposed by pandemics and rising antibiotic resistance have sparked a shift.
One of the biggest obstacles is still the lack of knowledge regarding the significance of adult vaccination. Adults are often thought to have adequate immunity to fend off illnesses, which results in poor vaccine study enrolment and a dearth of reliable safety data. In the absence of thorough research, policies stay the same, and adult vaccination does not get the traction it needs.Dr. Syeda Samreen, Adult Vaccination Advisor
Healthy ageing is a universal right, a journey that should be supported and not hindered. As we age, our bodies undergo various kinds of changes, one of the most significant being the natural decline of the immune system, a phenomenon known as immunosenescence. Older adults become more vulnerable to infections and diseases that can cause serious health issues or even shorten their lifespan.
Immunosenescence is defined as the gradual deterioration of the immune system’s ability to identify and respond to foreign particles, pathogens, and vaccines effectively. The production of immune cells by our body decreases as we age, and the ability to create a strong immune response weakens. This leaves older adults more susceptible to infections and makes it harder for their bodies to recover from illnesses.
Healthy aging is influenced by a number of factors, such as access to healthcare, genetics, lifestyle, and environment. A happy aging process is mostly dependent on preserving mental health, treating chronic illnesses, eating a healthy diet, and engaging in regular physical activity. A supportive community setting and social interaction are also important factors in promoting an individual's general health as they age.
Immunisation is a crucial part of their overall healthcare, helping to ensure that every human lives longer and in better health.
Previously seen as supporting staff, clinical pharmacists are now emerging as frontline advocates. Specialists in monitoring high-end antibiotics, modifying anticoagulant dosage, optimising therapeutic regimens, and ensuring medication safety, clinical pharmacists have traditionally played a crucial role in hospital ecosystems. However, changing public health challenges have created a need for their expertise beyond inpatient care.
At the forefront of this movement is Rainbow Children’s Hospitals, where clinical pharmacists are not just supporting physicians- they are leading vaccine advocacy, counseling, advising individualised vaccination regimens, and safety monitoring efforts under the Adult Vaccination Outreach Network (AVON) initiative.
The Adult Vaccination Advisor is a new role that has emerged at the intersection of clinical pharmacy and preventive medicine. This role is beginning to transform India’s approach to adult vaccination, an often overlooked aspect of healthcare.
Their role begins with a thorough pre-vaccination assessment, where they meticulously evaluate patients’ medical and medication histories, allergy profiles, and vital signs to ensure that the vaccines are administered safely and appropriately. Educating patients through one-on-one counseling helps in creating awareness about the often overlooked aspect: adult immunisation in a low- and middle-income setting.
These advisors engage in patient-centric counseling based on evidence-based guidelines from the Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP), and the Indian consensus guideline by the Association of Physicians of India (API). Through these counseling sessions, the benefits and potential risks of vaccination are addressed, fostering trust and informed decision-making.
What makes their role unique is the depth of personalised care they provide. These advisers don’t just talk about vaccines- they listen with empathy. It’s a detailed risk-benefit analysis through which they tailor an individualised vaccination regimen and promote evidence-based life-course immunisation.
And the decision? It’s always the patient’s. The adviser’s job is to educate, not enforce. Once the patient decides to take a step towards preventive healthcare, the advisor takes consent and advises the vaccine. Recognising their clinical expertise, Rainbow Children’s Hospitals has given them the privilege to recommend and countersign the vaccination prescription. Once vaccinated, patients are monitored for side effects and are managed clinically if any reactions occur.
Through the AVON initiative, Rainbow Children’s Hospitals is setting a new benchmark in preventive care, illustrating how clinical pharmacists can be powerful advocates for adult vaccination and play a central role in promoting healthier communities.
Adult Vaccine Access is hampered in low- and middle-income (LMIC) nations like India by issues such as low public awareness, inadequate healthcare infrastructure, and limited affordability.
Expanding preventive healthcare without adding strain to already overburdened medical personnel is a feasible and scalable solution that clinical pharmacists offer. They turn routine patient interactions into powerful opportunities to deliver life-saving preventive care by integrating vaccination counseling into outpatient care.
Higher costs compared to childhood schedules, the complexity of adult vaccination protocols based on age and comorbidities, and the absence of dedicated infrastructure further add to the challenge. While we cannot claim that vaccination alone will make our country disease-free, it will undoubtedly reduce mortality from vaccine-preventable diseases, enhance quality of life, and improve life expectancy.Dr. Syeda Samreen, Adult Vaccination Advisor
Immunization is a need, a right, and a duty for adults- it is not a luxury. With their scientific expertise and patient-centred approach, clinical pharmacists are not only part of the healthcare system but are shaping its future. Whether in a hospital hallway, a business camp, or beside a street vendor cart, every conversation about vaccines is an opportunity to save a life. It's more than just a role- it’s a movement. One patient, one prescription, and one policy at a time.
MSM/DP