Which adult populations are at higher risk for vaccine-preventable diseases and require targeted immunisation strategies?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Adult populations at higher risk for vaccine-preventable diseases and who require targeted immunisation strategies include:

  • Older adults, particularly those aged 65 years and over, who are eligible for routine vaccinations such as influenza and pneumococcal vaccines .
  • Pregnant women, including trans and non-binary people who are pregnant, due to increased vulnerability to certain infections .
  • People with underlying medical conditions that increase risk, such as chronic respiratory, heart, neurological, kidney, or liver diseases; diabetes; haemophilia; and immunosuppression due to disease or treatment (including chemotherapy, radiotherapy, organ transplant recipients, HIV, and those on immunosuppressive therapies) ,,.
  • Individuals with asplenia or splenic dysfunction, including those with sickle cell disease or coeliac syndrome, who require specific vaccines like MenACWY, MenB, pneumococcal, and annual flu vaccines ,,,.
  • People with severe neurological disabilities or neuromuscular diseases that compromise respiratory function, such as cerebral palsy, multiple sclerosis, motor neurone disease, and related conditions ,.
  • Adults with morbid obesity (BMI ≥40 kg/m2), who are at increased risk of severe influenza ,.
  • Underserved groups facing barriers to vaccine access or uptake, including people who are homeless, asylum seekers, Gypsy, Roma and Traveller communities, people with learning disabilities, and those from some minority ethnic or religious backgrounds ,.
  • Housebound individuals or those living in care homes or residential settings who may have difficulty accessing vaccination services .

Targeted immunisation strategies should address these groups’ specific barriers to vaccination, including tailored communication, accessible service locations and times, and involvement of community representatives to improve uptake ,.

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