Low adoption of adult vaccination: Over 90 per cent doctors say absence of guidelines a major cause

New Delhi: Only 16 per cent of the people aged 50 and above have taken any adult vaccine even though 71 per cent of those in the age group are aware of it, with a majority of doctors citing the absence of formal guidelines as a major cause for the lack of adoption of adult vaccination, according to a survey.

The survey was conducted recently by the Association of Physicians in India (API) and Ipsos, a global market research and polling firm, in 16 cities among those aged 50 years and older, their caregivers and doctors. 

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It yielded compelling insights into why there is a low adoption of adult immunisation in India, they said.

The survey was conducted among 1,950 adults above 50 years of age, 409 caregivers and 345 doctors from February to March 2023.

The qualitative part of the survey was conducted with 30 adults above the age of 50 years and their caregivers and 30 doctors from January to February 2023.

The second part of the survey was conducted with shingles patients to understand the level of awareness and impact of this condition on the lives of patients.

The survey shows that although 71 per cent of adults aged 50 years and above are aware of adult vaccination, only 16 per cent have taken any adult vaccine. Patients and doctors have provided significantly different reasons for low adoption.

Ninety per cent of the doctors surveyed state that a lack of formal guidelines results in a lack of interest and adoption of vaccination by patients, the study showed.

Doctors also hesitate to discuss adult vaccination with their patients because they have limitations of time and they also feel patients are less receptive to vaccination recommendations due to cost as well as prioritisation of treatment over prevention.

Patients said that since they do not receive a firm recommendation from their doctors, they have not proactively taken adult vaccination.

Many adults aged 50 years and above (69 per cent ) and their caregivers (76 per cent) do not ask doctors about adult vaccination because they believe that if they needed it, their doctors would recommend it.

When asked about how to improve adult vaccination uptake, adult respondents (55 per cent) and their caregivers (48 per cent) said that measures such as those implemented for COVID-19 vaccination awareness can increase the adoption of adult vaccination.

In New Delhi, 63 per cent of those surveyed were aware of adult vaccination, but only two per cent have taken any adult vaccine.

Doctors in New Delhi have recommended adult vaccines to only 10 per cent of ageing adults and only to those who ask for them.

Dr Agam Vora, secretary of the Association of Physicians of India, said measures need to be taken to increase the confidence of doctors in recommending vaccination for adults aged 50 years or older. “This is possible if formal guidelines on adult immunisation are set and widely shared. Programmes that address concerns, debunk myths, and remind patients and their caregivers frequently to ask doctors about adult vaccines can also drive adoption.

“Our survey also reveals that awareness of vaccine preventable diseases such as shingles is very low in India. We believe that only when adults aged 50 years and above are given complete information about the negative impact of VPDs (vaccine preventable diseases), will they take immunisation seriously,” he said.

He also stressed on acknowledging the role that caregivers can play in improving the uptake of adult vaccination and create awareness programs that target them.

Certain misconceptions about adult vaccination also hold back adults from getting vaccinated. More than half of those surveyed (58 per cent) and their caregivers (62 per cent) feel that there are better ways than vaccination to protect themselves or their parents/in-laws from diseases. Fifty per cent of them also believe that multiple doses of vaccines can make them dependent on vaccines.

In Delhi, 69 per cent adults aged 50 years or older feel the same and 63 per cent believe that diseases other than COVID-19 are not severe enough to require vaccination.

Since shingles is an important vaccine-preventable disease (VPD) amongst adults aged 50 years or older and there is low awareness about its prevention through vaccination, the second part of the survey was conducted with shingles patients to understand the level of awareness and impact of this condition on patients.

The shingles survey shows that awareness about the condition is low in the country.

It showed 72 per cent were unaware of shingles before they got it. Even after they got it, 73 per cent of patients were not aware that they can get shingles again.

Chronic conditions such as diabetes and hypertension were reported by 66 per cent of patients surveyed which made them more vulnerable to getting shingles and reinforced the need for such patients to get vaccinated.

The cities in which the survey was conducted were Delhi, Kolkata, Mumbai, Ahmedabad, Bengaluru, Chennai, Hyderabad, Lucknow, Jaipur, Chandigarh, Varanasi, Surat, Bhopal, Vijayawada, Thiruvananthapuram and Raigarh.