Breathing at Risk: India’s Overlooked Adult Vaccine Crisis

June 2026 : A few months ago, a 62-year-old man was rushed to the ICU with severe breathlessness. He had lived with asthma for years and managed it reasonably well. What nearly cost him his life was not asthma itself—it was influenza. What began as what seemed like a routine viral infection quickly escalated. Within days, his oxygen levels dropped, his lungs began to fail and his family found themselves facing a medical emergency they never anticipated.

The most troubling part? It may have been preventable.

He had never received an influenza vaccine—and like many Indians, he did not even know adult vaccines were recommended.

India has made remarkable progress in childhood immunization, becoming a global public health success story. But when it comes to adult vaccination, the country has a dangerous blind spot. A large proportion of Indian adults remain unvaccinated against preventable respiratory infections. At a time when India is grappling with worsening air pollution, a rapidly aging population, and a growing burden of chronic respiratory illnesses, this gap is becoming increasingly concerning.

Lower respiratory infections continue to cause millions of illnesses and deaths worldwide each year. In India, these risks are often amplified by delayed healthcare access, high rates of chronic illness and environmental exposures such as poor air quality. For people living with chronic respiratory diseases such as COPD, asthma, bronchiectasis, or interstitial lung disease, even common respiratory infections can become life-threatening.

Illnesses such as influenza, COVID-19, pneumococcal pneumonia, and Respiratory Syncytial Virus (RSV) can trigger severe exacerbations, hospitalizations, prolonged recovery and sometimes respiratory failure. The risk extends beyond lung disease. Older adults, pregnant women, healthcare workers, nursing home residents and people living with diabetes, kidney disease, liver disease, cancer, or weakened immune systems are also at significantly higher risk.

Yet one of the simplest tools to reduce this burden remains underused: vaccination.

Annual influenza vaccines reduce severe illness and hospital admissions. Pneumococcal vaccines help prevent serious pneumonia and bloodstream infections. Updated COVID-19 boosters continue to protect vulnerable groups, and newer RSV vaccines are expanding protection for older adults. These vaccines do more than prevent infections—they reduce ICU admissions, prevent flare-ups of chronic disease, lower healthcare costs and save lives.

So why are so few adults getting vaccinated?

The biggest barrier is awareness. Adult vaccination rarely becomes part of routine medical conversations. Many people still believe vaccines are only for children. Limited insurance coverage and the absence of widespread adult immunization programs further widen the gap.

The result is a silent vulnerability: millions of Indian adults remain unprotected against infections that are often preventable.

We often think about health only when illness becomes severe. But lung health does not begin in the ICU—it begins much earlier, with prevention. India transformed childhood vaccination through awareness, policy support and public trust. It is time to bring that same urgency to adult immunization.

The next time you visit your doctor, ask a simple question:

“Am I due for any vaccines?”

That conversation could prevent the next medical emergency.

Author Information:

Dr Apurv Mathur
MD Respiratory Medicine

Working in:
Department of Respiratory Medicine
ESIC Medical College and Hospital, Jaipur

Contact: 9950228500
Email: mathurapurv04@gmail.com

▪ Publications:

• Published article: Mathur A. Nerandomilast in ILD: A New Frontier in Anti-Fibrotic Therapy. Published in Lung Rajasthan (Official Newsletter of Rajasthan State Chapter of Indian Chest Society), September 2025; Volume 1, Issue 13: Pages 10–13.

• First author: Mathur A, Mishra M, Maan L, Mehta B, Patel J, Jha N, Vashist T. Clinical Profile of Non-Tubercular Pleuropulmonary Infections in Diabetes Mellitus. RUHS Journal of Health Sciences. Published online ahead of print, 2026. doi:10.37821/ruhsjhs.xxxx

• Co-author, “Pulmonary Function Abnormalities Among Treated Cases of Pulmonary Tuberculosis,” European Journal of Cardiovascular Medicine, Vol. 15, Issue 2, Feb 2025, pp. 488–492.

▪ Paper Presentations (State and National Level Conferences):

• Winner paper presentation, RAJPULMOCON 2023

• Paper presented in national conference, BWC 2023