Why adults need vaccines
Immunity from some childhood vaccines wears off, and a few vaccines are advised only for adults. Older people, and people with long-term illnesses such as diabetes, heart disease, lung disease and cancer, are more prone to infections. Studies reviewed in the Indian Journal of Medical Research found many adults without protection against diphtheria and tetanus.
India's national programme vaccinates adults only in pregnancy. Other adult vaccines are advised by medical societies, including the Association of Physicians of India (API), and by bodies abroad such as the US Centers for Disease Control and Prevention (CDC) and WHO. The table says who advises what.
Vaccines commonly advised for adults
In the table, API means the Association of Physicians of India's 2024 consensus guideline, as summarised in a review in the Indian Journal of Medical Research. CDC means the US adult schedule. Neither is India's national policy.
| Vaccine | Who is advised | Advised by |
|---|---|---|
| Tetanus, diphtheria and whooping cough (Td or Tdap) | All adults: a booster every 10 years. Tdap in every pregnancy | API, CDC |
| Flu (influenza) | Every year. API lists it for all adult age groups | API, CDC, WHO |
| Hepatitis B | Adults not vaccinated in childhood, including people with long-term kidney or liver disease, and health workers. CDC: all adults to age 59, and older adults with risk factors | API, CDC |
| Pneumococcal (against pneumonia) | Age 50 and over. CDC also advises adults aged 19 to 49 with conditions such as diabetes, long-term heart, lung or liver disease, kidney failure or smoking | API, CDC |
| Shingles (herpes zoster) | Age 50 and over. CDC advises two doses | API, CDC |
| HPV | API lists it for ages 18 to 49. CDC: routine to age 26, a shared decision with the doctor from 27 to 45 | API, CDC |
| MMR and chickenpox (varicella) | Listed for ages 18 to 49 | API |
| RSV | Older adults. API lists it above age 60. CDC: from 75, and 50 to 74 if at higher risk | API, CDC |
| Travel, work or extra risk | Yellow fever for travel to a country where it occurs. Typhoid, hepatitis A, Japanese encephalitis and rabies when there is extra risk, such as through work or travel | API |
Flu vaccine every year
WHO recommends flu vaccination every year for pregnant women, children aged 6 months to 5 years, people over 65, people with long-term medical conditions and health workers. Protection from the fades over time, which is why it is repeated every year. In older people the vaccine may work less well, but it can still make illness milder and lower the risk of complications.
Vaccines in pregnancy
India's national programme gives Td (tetanus and adult diphtheria) to pregnant women. The first dose is given early in pregnancy and the second four weeks later. A woman who had two doses in an earlier pregnancy within the last three years has one booster dose instead. The vaccine protects mother and newborn against tetanus and diphtheria.
API and CDC advise one dose of Tdap in every pregnancy, ideally between 27 and 36 weeks. WHO recommends yearly flu vaccination for pregnant women, who are at greater risk of severe illness from flu.
MMR and chickenpox vaccines are not given during pregnancy. CDC advises giving them after the birth, before leaving hospital, if the woman is not immune. vaccination is also left until after pregnancy.
Before you have a vaccine
Do
- Take your old vaccination records, including any childhood card
- Tell the doctor if you are or may be pregnant, have a long-term illness, or have allergies
- Ask which vaccines are advised for your age and work, and which are available near you
Do not
- Do not assume childhood vaccines protect you for life
- Do not have MMR or chickenpox during pregnancy
- Do not skip the flu vaccine because you had one last year
Common questions
I had all my childhood vaccines. Do I need more?
Possibly. Some protection fades, and a few vaccines, such as the shingles vaccine, are advised only for adults. A tetanus booster is advised every 10 years. Your doctor can go through your history with you.
Does one flu vaccine protect me for life?
No. WHO recommends a flu vaccine every year because protection fades over time. In older people it may work less well, but it can still make illness milder and lower the risk of complications.
Is the tetanus vaccine safe in pregnancy?
Tetanus vaccine (Td) is part of routine care in pregnancy in India. It protects the mother and the newborn against tetanus and diphtheria. Your doctor will say when to have it.
Can I get adult vaccines under the national programme?
India's national programme vaccinates adults only in pregnancy. For other adult vaccines, ask your doctor or a health centre which ones are advised for you and where they are available.