Adolescent immunisation in India: need of the hour

Although adolescents constitute one-fifth of India's population, the National Immunisation Programme in our country primarily focuses on the under five children, with barely a provision of tetanus toxoid ( TT) vaccine for adolescents. While Universal Immunisation Programme has resulted in the decline in incidence of vaccine preventable diseases among children, several unimmunised adolescents have become more susceptible to these diseases. Hence, there is an urgent need to take a re-look at the National Immunisation Schedule to incorporate vaccines for adolescents. Vaccines may be categorised as routine, catch-up and optional vaccines according to the appropriateness and feasibility. Minor modifications such as TT vaccine may be replaced by Td for 10 and 16 years as part of routine immunisation. Hepatitis-B vaccine and Measles and Rubella vaccine may be given as catch-up vaccines. JE vaccine should be included for all adolescents in endemic states in view of the age shift in the incidence of the disease. More research and cost-effective analysis needs to be conducted for newer vaccines such as HPV and Hib. Effective planning of immunisation services for the adolescent will require careful weighing of the advantages and disadvantages of each individual vaccine. Resources need to be channelised to carry out the mammoth task of vaccinating the adolescents at the service delivery points keeping in mind the other issues of vaccine efficacy, cost, adverse events and maintenance of cold chain. Above all parents, service-providers, government as well as adolescents themselves have to be sensitised and made aware of vaccination for adolescents.