Why Indians skip the flu vaccine despite risks
Every year, as flu season nears, doctors in India urge people to take the quadrivalent influenza vaccine (QIV), a preventive shot offering one-year protection against four major flu strains. Despite its benefits, the vaccine remains underused in India, limited by low awareness and a high cost of ₹1,500–2,500 per dose, The Times of India (ToI) reported.
QIV, safe for anyone above six months of age, is especially recommended for children, senior citizens, pregnant women, those with comorbidities, and healthcare workers. It guards against two influenza A strains (H1N1 and H3N2-like viruses) and two influenza B lineages. Globally, flu shots are part of routine healthcare.
“Most guidelines recommend all persons aged six months and older, except those with contraindications, to receive seasonal influenza vaccination annually. This is standard in many countries,” said Dr Rommel Tickoo, director, internal medicine, Max Hospital, Saket, as quoted by ToI.
In India, however, uptake is poor since the flu vaccine is not part of the government’s Universal Immunization Programme, which covers TB, DPT and polio. “The Indian Academy of Pediatrics recommends starting flu vaccination after six months of age, with two doses in the first season for younger children. The vaccine is available mostly in the private sector, through hospitals, clinics, and vaccination providers, and must be given under medical supervision,” Tickoo told ToI.
“Seasonal flu vaccines are updated each year to match the most common circulating strains,” explained Neeraj Nischal, additional professor, Department of Medicine, AIIMS. “Current vaccines are quadrivalent and may be injectable or intranasal. Because immunity wanes over time, yearly vaccination is necessary.” Nischal added that WHO and national agencies update formulations twice a year after reviewing global flu data.
Experts also caution that flu shots are not foolproof. “The vaccine doesn’t protect against every strain or against every new mutation,” said Dr Rohit Kumar, associate professor and head, pulmonary medicine, Safdarjung Hospital. “Effectiveness depends on how closely the vaccine’s strains match what is circulating and on the individual’s immunity. For older adults or those with chronic illnesses, the protection may be weaker. But what we do know is that illness is usually less severe if you are vaccinated, with fewer chances of complications, hospitalisation or death. Recovery is quicker too.”
Cost and the need for prescriptions add further barriers. “A doctor’s prescription is required before vaccination, especially in hospitals and clinics. This ensures the vaccine is suitable for the patient, the correct dosage is administered, and precautions are followed,” said Dr Suranjit Chatterjee, senior consultant, internal medicine, Indraprastha Apollo Hospitals. “The vaccine in India typically costs ₹1,200–2,000 per dose, depending on the brand and hospital. Administration charges can be extra.”
Lack of data is another challenge. “There is no concrete national data on influenza vaccination, but smaller surveys give us a picture,” said Dr Sanjeet Panesar, professor, community medicine, ABVIMS and RML Hospital. “Hospital records suggest only around 1.5% of adults coming to hospitals are vaccinated, that is roughly 15 of every 1,000 individuals. Some surveys show 11% of people get the flu shot annually, while among healthcare workers, the numbers vary between 8% and 34%. Overall, 1–2% of India’s population has ever received a flu vaccine in their lifetime.”
Despite strong medical consensus on its importance, the flu shot continues to remain off the radar in India, leaving most of the population exposed to a seasonal illness that can sometimes become severe.
With inputs from ToI
QIV, safe for anyone above six months of age, is especially recommended for children, senior citizens, pregnant women, those with comorbidities, and healthcare workers. It guards against two influenza A strains (H1N1 and H3N2-like viruses) and two influenza B lineages. Globally, flu shots are part of routine healthcare.
“Most guidelines recommend all persons aged six months and older, except those with contraindications, to receive seasonal influenza vaccination annually. This is standard in many countries,” said Dr Rommel Tickoo, director, internal medicine, Max Hospital, Saket, as quoted by ToI.
In India, however, uptake is poor since the flu vaccine is not part of the government’s Universal Immunization Programme, which covers TB, DPT and polio. “The Indian Academy of Pediatrics recommends starting flu vaccination after six months of age, with two doses in the first season for younger children. The vaccine is available mostly in the private sector, through hospitals, clinics, and vaccination providers, and must be given under medical supervision,” Tickoo told ToI.
“Seasonal flu vaccines are updated each year to match the most common circulating strains,” explained Neeraj Nischal, additional professor, Department of Medicine, AIIMS. “Current vaccines are quadrivalent and may be injectable or intranasal. Because immunity wanes over time, yearly vaccination is necessary.” Nischal added that WHO and national agencies update formulations twice a year after reviewing global flu data.
Experts also caution that flu shots are not foolproof. “The vaccine doesn’t protect against every strain or against every new mutation,” said Dr Rohit Kumar, associate professor and head, pulmonary medicine, Safdarjung Hospital. “Effectiveness depends on how closely the vaccine’s strains match what is circulating and on the individual’s immunity. For older adults or those with chronic illnesses, the protection may be weaker. But what we do know is that illness is usually less severe if you are vaccinated, with fewer chances of complications, hospitalisation or death. Recovery is quicker too.”
Cost and the need for prescriptions add further barriers. “A doctor’s prescription is required before vaccination, especially in hospitals and clinics. This ensures the vaccine is suitable for the patient, the correct dosage is administered, and precautions are followed,” said Dr Suranjit Chatterjee, senior consultant, internal medicine, Indraprastha Apollo Hospitals. “The vaccine in India typically costs ₹1,200–2,000 per dose, depending on the brand and hospital. Administration charges can be extra.”
Lack of data is another challenge. “There is no concrete national data on influenza vaccination, but smaller surveys give us a picture,” said Dr Sanjeet Panesar, professor, community medicine, ABVIMS and RML Hospital. “Hospital records suggest only around 1.5% of adults coming to hospitals are vaccinated, that is roughly 15 of every 1,000 individuals. Some surveys show 11% of people get the flu shot annually, while among healthcare workers, the numbers vary between 8% and 34%. Overall, 1–2% of India’s population has ever received a flu vaccine in their lifetime.”
Despite strong medical consensus on its importance, the flu shot continues to remain off the radar in India, leaving most of the population exposed to a seasonal illness that can sometimes become severe.
With inputs from ToI
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