Knowledge, Attitude, and Practice of Adult Immunization in a Tertiary Care Hospital in South India: A Cross-sectional Study

disease, with a paucity of age-stratified data.5 Each year, India accounts for approximately 40-45 million cases of communityacquired pneumonia.6 Lower respiratory infections, 7 particularly pneumococcal pneumonia, 7,8 are prevalent and account for a significant amount of mortality.Adults suffering from varicella, 9 herpes zoster, 10 and influenza 11 are poorly vaccinated even though these diseases are highly prevalent.In India, cervical cancer ranks as the second most prevalent cancer among women.High-risk human papillomavirus (HPV) types 16 and 18 are responsible for around 80% of cervical cancer cases.12 For adult vaccine -prevent able diseases, the CD C and Indian health guidelines provide more or less the IntroductIonPreventing disease is the most economical way to safeguard and enhance public health, with vaccination playing a crucial role in this effort.It is advisable to receive vaccinations at all stages of life to avoid infectious diseases and their potential complications. 1 In India, there have been notable improvements in childhood vaccinations through the Universal Immunization Programme (UIP).However, there are gaps in vaccination coverage for adults that need to be addressed.2 The changing demographics of the population, which include an increase in older adults, the phenomenon of globalization, and the presence of more immunocompromising conditions, such as acquired immunodeficiency syndrome (AIDS) and organ transplantation, affect the epidemiology of diseases and increase the susceptibility of adults to infections.While the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) advocate for the need to vaccinate adults, there are very few opportunities to do so in India's integrated health system. 1 India accounts for 18% of the world's population 3 and stands as the largest contributor to the global burden of vaccinepreventable diseases.In 2017, India accounted for 40% of the global burden of tetanus, 44% of Japanese encephalitis, and 60% of diphtheria cases.4 The Integrated Disease Surveillance Programme, which recorded 990 to 2,679 outbreaks between 2010 and 2017, reported that the majority of outbreaks were due to diseases such as measles, varicella, and diarrheal 1-8,