We Vaccinate Children. Why Forget Elders? I'm protecting my parents with these 3 vaccines!

Roughly 6 lives saved every minute, thanks to vaccinations - an estimate by WHO-led analysis published in The Lancet that vaccination against just 14 diseases has saved at least 154 million lives over the past 50 years (Shattock et al., 2024)! But, we (us as individuals and esp. Indian Govt programs) spend so much time making sure children receive their vaccines and seem to forget that vaccination does not end in childhood. 

So, as someone who firmly believes that prevention is better than cure (you'd be surprised how often we don't actually practice that principle!), I learnt about these when our parents enquired our family doc about flu vaccine (indicating my own limited awareness suggestions). And, once I read more about it, I have been telling all my friends about it with parents over 60. Especially, if your parents have diabetes, please have this conversation with your doctor in the next visit. 

1. Shingrix - for shingles 

2. Prevenar 20 - for pneumococcal disease 

3. Influenza vaccine - every year 

(Poster made with AI, data researched by me, still double-check information)

Let me share a brief about these.

I. Shingrix: the shingles vaccine 

My father-in-law recently told us that, on his doctor's recommendation, he had received an injection costing ₹21,000 for shingles! My immediate reaction was: ₹21,000 for one vaccine?! Then I started reading about shingles. 

Shingles isn't a new infection you catch from somewhere.  If you've had chickenpox previously, the virus (varicella-zoster virus) doesn't completely leave your body after you recover. It becomes dormant in nerve tissue, and decades later, as our cell-mediated immunity naturally declines with age, that same virus can reactivate causing shingles. I feel silly now to think since I've had chickenpox once, I never have to worry of it again!

Shingles can be horribly painful. It usually causes a painful, blistering rash, often appearing as a band on one side of the body. But the rash isn't necessarily the worst part. Some people develop post-herpetic neuralgia (PHN), persistent nerve pain in the area where the rash used to be. That pain can continue for months or even years after the rash has disappeared, and both the likelihood and severity of PHN increase with age. Shingles can also occasionally affect the eyes or ears and cause complications involving vision, hearing or the nervous system. Diabetes makes this even more relevant.  A systematic review and meta-analysis found that people with diabetes had about a 38% higher risk of developing shingles than people without diabetes (Huang et al., 2021). So if one of your parents is older and diabetic, this is particularly worth discussing. 

How effective is Shingrix? Very. In the pivotal clinical trial involving adults aged 50+, two doses of the recombinant shingles vaccine reduced the risk of shingles by 97.2% compared with placebo (Lal et al., 2015). Protection remains very strong in older age groups too: the CDC currently summarises effectiveness at about 97% in adults aged 50–69 and 91% in people aged 70+ with healthy immune systems (CDC, 2026). 

How many doses? Two doses. They are normally given 2–6 months apart. So while two months is a common schedule, it doesn't have to be exactly two months. 

How much does it cost in India? As I write this in Sep 2026, Tata 1mg lists Shingrix at: ₹10,008 per dose with discount. So the complete two-dose course is roughly ₹20,000–₹22,000 per person at retail prices. Yes, that's expensive. But if we are fortunate enough to be able to plan for it, let's protect our elders from suffering years of horrific pain.

These vaccines need proper refrigerated storage at 2–8°C. Online pharmacies such as 1mg do state that Shingrix is cold-stored, but personally I would still prefer having an injectable vaccine supplied and administered directly through a clinic or hospital I trust. If you're around Secunderabad and want to know where we're getting ours done, DM me and I'm happy to share. 

Should they get a vaccine if they've suffered shingles already? Possibly, yes. Apparently, having shingles once does not mean you can never get it again. Current CDC guidance recommends Shingrix even for people who have previously had shingles. It isn't given during an active episode; once the acute illness/rash has resolved, their doctor can advise on timing.

Why is Govt doing nothing? Good question. Unfortunately in India, this is not even a notifiable disease and there's no data on incidence and disease burden (Ramasubramanian et al., 2023). One study estimates 45 lakh shingles cases annually (Varghese and Mishra, 2025)!! But atleast, Shingrix has been made available in India since Apr 2023 - and we need activists, campaigners, politicians to care and demand for a massive free vaccination drive. But, until then, those who can, please get this!

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II. Prevenar 20: protection against pneumococcal disease

Prevenar 20 protects against 20 serotypes of a bacterium called Streptococcus pneumoniae, or pneumococcus, that can cause several serious illnesses, including:

• pneumonia - infection of the lungs;
• meningitis - infection of the membranes surrounding the brain and spinal cord;
• bacteraemia - bacteria entering the bloodstream;
• and potentially sepsis.

It does not prevent every type of pneumonia or every type of meningitis but specifically protects against disease caused by the pneumococcal strains included in the vaccine.

Why does age matter? 

Once again, 

vulnerability to serious pneumococcal disease increases with age. 

Diabetes, chronic heart disease, lung disease, kidney disease, smoking and immune suppression can increase the risk further.

Recent Indian adult-immunisation guidance has also incorporated PCV20 into the available adult vaccination options (Association of Physicians of India (API) recommendations on adult immunization, 2026).

How much does Prevenar 20 cost? 

Current Indian retail pricing is approximately 

₹5,277, 

and is generally a single injection for a previously unvaccinated adult when PCV20 is the selected schedule.

How many doses? Just one. And this vaccines is available in India since Aug 2025!

What if they've already had pneumonia? There are more than 100 known pneumococcal serotypes. Infection with one doesn't necessarily give immunity against the others. So even someone who has previously had pneumococcal pneumonia can still be a candidate for vaccination.

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III. The humble flu vaccine - every year

This one costs much less and is perhaps the easiest to overlook. Older adults should receive influenza vaccination every year. 

Why every year? Because influenza viruses continually change, vaccine formulations are updated to better match circulating strains, and the immunity generated by vaccination also decreases over time.

Flu isn't merely an unpleasant fever and cough for an older person. Older adults and people with chronic illnesses such as diabetes and cardiovascular disease have a greater risk of severe influenza, pneumonia, hospitalisation and death. WHO specifically identifies older adults and people with chronic medical conditions as priority groups for seasonal flu vaccination (WHO, 2026).

What's the cost? Current Indian retail listings for the 2026 flu vaccines vary by product. For example, Influvac Tetra 2026 is around ₹2,285, while a 2026/27 formulation is listed around ₹2,950. Prices and available formulations will vary between hospitals and seasons.

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And while you're at it, also review tetanus/Tdap, Hep A/B, Typhoid and other adult vaccines too with your doctor. Individual medical conditions can change what is recommended.

This post is not a prescription and I wouldn't buy vaccines and administer them based on a social-media post ever! Take your parent's age, medical history, medication list and previous vaccine history to their physician and specifically ask for a vaccination review!

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Why I had to share about this?

I was bothered to realise that I did not even hear about Shingrix or Prevenar despite being in the public health sector (although WASH). I atleast had internalised vaccination as something meticulously organised for children and then largely stop thinking about once adulthood begins. My journey with University of Leeds taught me how countries here truly prioritise vaccines for adults too, and one that I dearly wish India to get on board with.

Why isn't adult vaccination discussed as routinely as childhood vaccination? Why isn't healthy ageing accompanied by a clear vaccination schedule that every family knows about? And yes, there's a larger public-health conversation here about affordability and access. A ₹20,000+ shingles course is simply not affordable to every Indian household.

While my instinct is always to ask the systemic question first. I've also learnt something over the years, that I can care about changing the system and start with the people immediately around me. Put your own oxygen mask on first, then help the next person - innit?! So I'm starting here.

If even a few friends read this, call their parents and get to planning their vaccinations - this post has done something useful.

P.S. and for those who travel between India/ UK, checkout and consult about the chikangunya and Dengue vaccines too that unfortunately are not available in India yet!

And, if you have found this helpful, please share it forward, and let's all protect our elders <3

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