Vol. 7, Issue 2, Part A (2025)

Background: India’s ageing population (≥60 years) is projected to grow from 153 million (11.2%) in 2025 to 347 million (20.8%) by 2050 and (Use 2025 consistently across Abstract + Introduction.) Older adults will account for ~45% of the national disease burden by 2030, with high prevalence of comorbidities (~75% having ≥1 chronic disease). Vaccine-preventable diseases (VPDs) such as influenza, pneumonia, herpes zoster, and hepatitis pose significant risks, yet adult vaccination remains neglected, as programs have historically focused on children and maternal health. The COVID-19 pandemic highlighted seniors’ vulnerability and the potential of digital platforms for large-scale immunisation.

Objective: This study assesses the health and economic impact of life-course vaccination in India’s elderly population and explores digital health integration for a sustainable vaccination model.

Methods: Demographic and disease-burden data were analysed from national and global sources. Literature on VPD burden, cost-effectiveness, and health system capacity was synthesised. A health economic model projected outcomes (2025-2050) under scenarios of enhanced adult vaccination versus status quo, incorporating assumptions on vaccine efficacy, coverage, and healthcare costs. Case studies, including India’s Co-Win platform, informed a proposed digital workflow for adult immunisation.

Results: Indian seniors show high vulnerability and extremely low adult vaccine uptake (<5% among healthcare workers). Modelling suggests scaling up adult vaccines (e.g., influenza, pneumococcal, zoster) could avert millions of cases and hospitalisations, generating billions in healthcare savings. Each ₹1 invested in preventive health is estimated to return ~₹15-34. Digital tools—ABHA IDs, electronic registries, AI-driven risk stratification, and mobile apps can improve tracking, access, and efficiency.

Conclusion: Life-course vaccination can reduce morbidity, mortality, and costs among India’s elderly. Integrating adult vaccines into national programs and leveraging digital health innovations offers a sustainable path to healthy ageing and stronger pandemic preparedness.

Recommendation for Policy Makers (MOHFW, NITIAYOG, NDHM, Academia) To safeguard India’s rapidly ageing population, it is imperative that the Ministry of Health & Family Welfare (MOHFW), NITI Aayog, and the National Digital Health Mission champion the integration of Life-Course Vaccination (LCV) into national health policy. Leveraging India’s robust digital platforms- ABDM and Co-WIN can be updated & transform adult vaccination from a fragmented service into a core pillar of preventive care. A National Adult vaccination program must be established, prioritising vaccines such as influenza, pneumococcus, hepatitis B, and Tdap for seniors and high-risk groups. This must be digitally anchored: each citizen’s vaccination status tracked via ABHA-linked registries, nudges delivered through SMS/IVR, and clinics equipped with real-time dashboards. Integration with health benefit schemes like PM-JAY, CGHS, and ESIS, alongside inclusion in EHRs and NCD programs, will ensure reach, affordability, and sustainability. To scale impact, mobilise private clinics, pharmacies, and NGOs through open digital APIs and public-private partnerships. Train frontline workers via digital CME platforms and tackle hesitancy using data-driven behavioural nudges.