Towards Universal Adult Immunisation: Review of the 2026 Global and Indian Schedules

Adult immunisation is a vital yet underprioritised component of preventive healthcare, particularly in India, where the burden of vaccine-preventable diseases (VPDs) has shifted towards adults. Immunosenescence and rising chronic diseases amplify susceptibility; however, vaccination coverage remains poor due to low awareness and the lack of a national policy. This review consolidates the 2025 adult immunisation recommendations from global (Centres for Disease Control and Prevention [CDC], World Health Organisation [WHO]) and Indian (Associations of Physicians of India [API]) guidelines, with an emphasis on vaccine updates, risk-based strategies, and implementation challenges. A narrative review of official guidelines, peer-reviewed literature, and consensus statements published between 2020–2025 was performed, focusing on adult vaccination schedules, contraindications, and special-risk groups such as pregnant women, immunocompromised individuals, and those with chronic diseases. Key vaccines reviewed include influenza, pneumococcal, coronavirus disease 2019 (COVID-19), hepatitis A and hepatitis B, human papillomavirus (HPV), zoster, tetanus–diphtheria–acellular pertussis (Tdap), meningococcal, measles-mumps-rubella (MMR), and varicella vaccines. Recent additions — respiratory syncytial virus (RSV) and monkeypox vaccines — expand protection for older and high-risk adults. Despite robust global frameworks, India faces barriers including limited awareness (4.9%), fragmented delivery systems, and inadequate provider advocacy. Strengthening adult immunisation through unified national policy, integration with chronic disease programs, and enhanced public education is imperative. Adopting a life-course vaccination approach will improve adult health outcomes and align India with World Health Organization (WHO) Immunisation Agenda 2030.