Table 3.
Summary of adult vaccination recommendations in India.
| Guidelines | Based on API42 and CDC45 | ISN40 | IMA41 | FOGSI43,44 |
|---|---|---|---|---|
| Diphtheria/tetanus/pertussis | Tdap once then Td 10-yearly; Tdap during each pregnancy | Td 10-yearly to 65 years; 3 doses if not immunized | Tdap 10–18 years (1 dose); Td 10-yearly; TT/Td early during pregnancy (2 doses); Tdap during third trimester of pregnancy (1 dose) | TT/Td 10-yearly; TT/Td or Tdap during pregnancy; Tdap if age ≥65 years, unvaccinated, and close contact with infant |
| MMR | 19–59 years (1 or 2 doses)a | Unimmunized (1 dose) | Adults (1 or 2 doses)a | MMR for routine preconceptional/postnatal (pregnancy should be deferred for 3 months) |
| Influenza | Yearly (1 dose); during pregnancy (1 dose) | At risk, including during pregnancy (1 dose)b | Yearly (1 dose); including pregnancy | Yearly; also during pregnancy |
| Pneumococcal | ≥65 years (1 dose); at riskb (1 or 2 doses) | ≥65 years (1 dose); at riskb | At riskb (2 doses) | – |
| HPV | Women ≤26 years (3 doses); men ≤21 yearsc (3 doses) | 9–26 years (2 or 3 doses) | Females 9–14 years: 2 doses; 15–45 years: 3 doses | 9–26 years; next dose(s) should be deferred in case of pregnancy |
| Varicella | 2 doses if no evidence of immunity (contraindicated during pregnancy) | Nonimmune (2 doses) | Adults (2 doses)a | Preconception/postnatal |
| Herpes zoster | ≥50 years (1 or 2 dose based on type of vaccine)d | >60 years (1 dose) | – | – |
| Hepatitis A | At riskb (2 or 3 doses) | At riskb (2 doses) | Adults (1 dose of live or 2 doses of inactivated) | – |
| Hepatitis B | At riskb (3 doses) | At riskb (3 doses) | Adults (3 doses) | Preconceptione or at high risk during pregnancy |
| Meningococcal | At riskb (1 to 3 doses) | At riskb (1 or 2 doses) | Adults (1 dose); At riskb (2 doses) | – |
| Hib | At riskb (1 or 3 doses) | At riskb (1 dose) | At riskb (1 or 3 dose) | – |
| Typhoid | 1 dose PSV repeat 2 yearly | Outbreak or high-risk travelers (3 doses, repeat 3-yearly) | ≤18 years: TCV 1 dose; >18 years: PSV 3 yearly |
– |
| Rabies | At riskb (3 or 4 doses)b | At riskb (3 doses) | At riskb (3 or 4 doses) | – |
| Cholera | 18–65 years (1 dose if traveling to endemic region) | At riskb (2 doses) | At riskb (2 doses) | – |
| JE | 2 doses; booster (in reexposure) if primary given >1 year ago | No | ≤18 years (1 dose) | – |
| Yellow fever | 1 or 2 doses based on immune status | – | At riskb | – |
| Polio | 1 to 3 dosesa | Travel to polio endemic countries (1 or 3 doses) | 2 doses of IPVa | – |
| Rotavirus | – | No | – | – |
aBased on vaccination history.
bThe definitions of “at risk” vary by guideline and by vaccine, but include factors such as chronic health conditions, age, occupations (e.g. healthcare workers, veterinarians), lifestyles (e.g. illicit drug users, men who have sex with men), after exposure, times of epidemic, and lack of prior vaccination.
c ≤ 26 years if they have sex with men.
dCDC does not recommend the use of Zostavax among those aged 50–59 years.
eSchedule completed before conception, usually 3 months prior to conception.
API, Association of Physicians of India; CDC, Centers for Disease Control and Prevention; FOGSI, Federation of Obstetric & Gynecological Societies of India; Hib, Haemophilus influenzae b; HPV, human papillomavirus; IMA, Indian Medical Association; ISN, Indian Society of Nephrology; JE, Japanese encephalitis; MMR, measles, mumps, rubella; PSV, Polysaccharride vaccine; TCV, Typhoid conjugate vaccine; Td, tetanus, diphtheria; Tdap, tetanus, diphtheria, acellular pertussis; TT, tetanus toxoid; US, United States.