As Kerala’s elderly population is projected to rise from the current 18.7% to 23% by 2036, the state has taken a major step towards adult immunization, allocating ₹50 crore in the last state budget to vaccinate the poorer elderly against the deadly pneumococcal disease.
This is an important step to protect the elderly population and reduce avoidable hospitalizations or complications due to respiratory infections. But it would make more sense — for health and economic reasons — for the state to introduce a flu vaccine alongside the pneumococcal vaccine to provide seniors with full coverage against respiratory infections, public health experts warn.
Neglected area
Adult vaccination remains a neglected, non-priority area in India, and the country still has no national guidelines for adult immunization and no robust data to track the burden of vaccine-preventable diseases in adults. Older adults and individuals with chronic diseases such as diabetes, cardiovascular disease, chronic respiratory conditions, and other immunocompromising conditions are at particularly high risk of serious consequences when affected by infectious diseases such as influenza or pneumococcal disease. Vaccination of the elderly significantly reduces the incidence and severity of infectious diseases, prevents hospitalization, reduces morbidity and mortality and improves the quality of life. Vaccinating adults also reduces wider societal costs by reducing hospitalization costs and the burden on carers.
In this context, the State Committee on Vaccine Policy, led by B. EKbal, recommended in 2021 that pneumococcal vaccines – 13-valent conjugate vaccine (PCV13) and 23-valent polysaccharide vaccine (PPSV23) – and the annual quadrivalent influenza vaccine be provided to people over 65 years of age.
“Infection with the flu virus is not just an ordinary fever, because it acts as a gateway to deadly pneumococcal bacterial infections. By disrupting the immune defenses of the lungs, the flu virus makes it easier for bacteria to enter the body and cause severe pneumonia. Such co-infections lead to severe morbidity and prolonged hospitalization in the elderly,” emphasizes Dr. Ekbal
In addition, the physical toll of influenza often results in critical conditions such as heart attacks and strokes, prolonged hospitalization, and a significant financial burden on the patient and the public health system.
Prevention of influenza and its subsequent cardiovascular complications can lead to massive reductions in overall government health care spending. “It makes more sense for the government to introduce a flu vaccine in addition to the pneumococcal vaccine, as this can lead to substantial economic savings for the government and the public. The vaccine distribution system that will be set up for pneumococcal vaccination can also be used for the flu vaccine,” points out Dr. Ekbal.
Published – 30 Jan 2026 20:34 IST
