Role of Pneumococcal Vaccination as a Preventative Measure for At-risk and High-risk Adults: An Indian Narrative.

Pneumococcal disease (PD) remains a significant public health concern, particularly in adults aged >50 years and individuals with comorbidities. India bears approximately 23% of the global burden of community-acquired pneumonia (CAP). The highest rates of morbidity and mortality are linked to Streptococcus pneumoniae-related invasive pneumococcal disease (IPD) in adults aged >50 years. Despite the availability of effective vaccines, including the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23), adult vaccination coverage in India remains suboptimal. A key barrier to adult vaccination is the lack of awareness, with over 80% of adults being unaware of the vaccines available for them. Many people still believe that vaccines are only for children, highlighting the need for better awareness among patients and healthcare providers. Additionally, the absence of dedicated adult vaccination centres limits access, making it crucial to establish such centres and involve trained personnel such as doctors, nurses, and pharmacists in raising awareness. Often, healthcare professionals (HCPs) do not consider underlying comorbidities as risk factors for the development of pneumococcal disease. Additionally, the evidence on vaccine efficacy is scattered. Given these challenges, there is a critical need for a comprehensive review synthesizing the available evidence on pneumococcal vaccination in high-risk and at-risk populations. This review aims to consolidate the most recent findings on the effectiveness of pneumococcal vaccination practices, highlighting the importance of adhering to vaccination guidelines to reduce the public health burden of PD.