Tamil Nadu lacks awareness on adult vaccines

Pneumococcal diseases, hepatitis, influenza, measles, mumps, typhoid, herpes, zoster, diphtheria, tetanus and human papillomavirus (HPV) infection are some of the diseases that can be prevented through vaccination. But, even though vaccines are more than 70 per cent effective against preventable diseases, the Universal Immunisation Programme (UIP) does not have an active vaccination programme for adults.

As per the State immunisation programme, all pregnant women and newborns need to be vaccinated against preventable diseases. But doctors say that youngsters remain unaware of adult vaccines available at government hospitals, mostly because healthcare professionals do not take the initiative to educate patients about vaccines for grownups.

“People believe that they receive all vaccinations in the childhood itself. But there are many vaccines that have to be administered after the age of 18. The key barriers preventing this are lack of knowledge on the need to vaccinate throughout adulthood and also trust in the medical practitioners. Tetanus, hepatitis A and B, influenza and HPV vaccines are important in the age group of 18 to 64. Doctors need to educate patients on their importance once signs of a vaccine-preventable disease surface,” says Dr V Ramasubramanian, senior consultant, Institute of Infectious Diseases, Apollo Hospitals.

“A misconception that vaccines are only for children needs to be addressed. There is a lack of awareness among the public and the recommendations for mandatory adult vaccines are not yet approved by the government,” the doctor adds.

‘Vaccinate for Life’, a 2018 survey conducted in Chennai to check awareness on adult vaccination, revealed that 41 per cent of adults were uninformed of the recommended vaccines. The survey found that while 33 per cent people considered vaccines required only during outbreaks or travel, 41 per cent thought it was only for newborns and babies. Thirty per cent of the adults believed vaccination was not required for healthy people.

This ignorance has disastrous effects. For instance, the lack of awareness on adult vaccination has resulted in the rise in cervical cancer cases. Even the cases of diphtheria in Tamil Nadu have increased from 133 in 2017 to 211 in 2018. Similarly, Hepatitis B, which spreads among youngsters due to unsafe syringes, drug abuse, sexual contact and blood transfusions, has seen an increase. Though vaccination is the key preventive measure for adults against these diseases, it takes a back seat in the immunisation programme.

Vaccination can also prove to be an effective tool to prevent influenza cases in the State, which has seen a rise in the recent days. However, the importance of influenza vaccines is emphasised only after the epidemic has already hit. “Because adult vaccination is voluntary, people do not turn up to get them administered unless they are affected. Some even believe that shots can have severe side-effects and are harmful to health. Though these vaccines are available at all government hospitals, seldom do people come on their own to get vaccinated unless they are infected,” says Director of Public Health Dr K Kolandaisamy.

The immunisation schedule-2019 under Universal Immunisation Programme has introduced HPV vaccination for women till the age of 18. But the State Health Department is yet to implement it. The HPV vaccine, which reduces the risk of cervical cancer, can be given to women till the age of 45.

“More than 20,000 cases of cervical cancer in the State can be averted if HPV vaccine is administered on all women. A recent study by The Lancet found that cervical cancer could be eliminated as a public health problem in India within the next 60 years by strengthening the screening programmes and prevention programmes such as HPV vaccine,” oncologist Dr Anitha Ramesh says.

According to State Health Department officials, the burden of vaccine-preventable diseases in neonatal and children is at a higher risk than adults. Hence, adult vaccination has taken a back seat. “There is a need to bring down cases of neonatal and maternal tetanus, diphtheria and whooping cough using vaccination and to eventually eradicate them. Vaccine for hepatitis B has been given to the clinics. We have started to administer the shots for pneumococcal diseases for elderly persons as well. However, a universal programme for adults is yet to be brought up,” Dr R Sathish Kumar, immunisation medical officer at Directorate of Public Health and Preventive Medicine, says.

Around 4,133 elderly persons living in old age homes in the State have been vaccinated against pneumococcal diseases. Vaccine shots have, however, not been given for any other diseases, he adds.