Adult respiratory vaccination in the Indian armed forces: Uptake, awareness, and opportunities for policy reform

Immunisation reduces morbidity and mortality from vaccine-preventable diseases (VPDs). While childhood vaccination in India has improved, adult immunisation remains insufficient, especially among individuals with non-communicable diseases (NCDs). We aimed to evaluate vaccination coverage, awareness, and influencing factors among adults in a tertiary Armed Forces hospital.

A cross-sectional observational study was conducted from April 2024 to April 2025 at an adult immunisation clinic in a tertiary Armed Forces hospital. Data from 2,645 adults were analysed using descriptive and inferential statistics to assess vaccine uptake and its association with demographic and clinical variables.

Among 2645 participants, 57.3% were male. Influenza (45%) and pneumococcal (47%) vaccines were most administered. Herpes zoster and Tdap vaccines had lower uptake (5.7% and 1.5%, respectively). Uptake was highest in those aged 60-70 years. Awareness of adult vaccination was noted in 24.56% and was significantly associated with higher uptake (P < 0.001). Prior hospitalisation also positively influenced vaccine acceptance (P = 0.02). Adverse events were predominantly mild (pain, swelling, fever) and showed no significant variation between vaccines.

Adult respiratory vaccination coverage remains suboptimal despite moderate influenza and pneumococcal uptake. Awareness and prior healthcare interactions significantly influence uptake. National adult immunisation strategies are urgently needed.