Life Course Vaccination Continuum (LCVAC): An Expert Consensus on Life Course Vaccination in India.

India's immunization program focuses predominantly on children, leaving adults vulnerable to vaccine-preventable diseases (VPDs). The COVID-19 pandemic further disrupted routine vaccination. A life course approach (LCA) is needed to address these gaps. However, implementation of adult vaccination programs in low- and middle-income countries (LMICs) remains challenged by inequities in healthcare access, infrastructural limitations, and variable awareness regarding adult immunization. A 16-member expert panel from pulmonology, geriatrics, oncology, obstetrics, nephrology, diabetology, and life sciences reviewed literature (2014-2023) from MEDLINE, Scopus, and Cochrane databases. Using a structured, evidence-based grading approach, the panel formulated consensus recommendations for adult vaccination in India. The Life Course Vaccination Continuum (LCVAC) proposes three target groups: adults aged 18-59 years with comorbidities; elderly ≥60 years with or without comorbidities; and healthy adults aged 18-60 years. Key recommended vaccines include Tdap (every 10 years), influenza (annual), pneumococcal (PCV13/PPSV23 series), zoster (for ≥50 years), hepatitis B, meningococcal, and hepatitis A (risk-based). Major barriers identified include vaccine hesitancy, cost, access limitations, and inadequate provider prioritization. Life Course Vaccination Continuum provides the first comprehensive expert consensus on life course vaccination in India. The framework is intended to complement broader public health strengthening efforts, and its successful implementation will require vaccine awareness campaigns, healthcare professional education, equitable access strategies, and the establishment of dedicated adult vaccination centers nationwide.