An article in The Hindu highlights a critical public health failure in India: the alarmingly low vaccination coverage among its older adult population. With nearly 130 million people aged 65 and above, less than 5% are protected by recommended adult vaccines, a stark contrast to the 75-90% coverage achieved under the Universal Immunisation Programme (UIP) for children. This significant 'reversed vaccine gap' leaves India's most vulnerable demographic susceptible to preventable diseases. Research consistently corroborates these findings, indicating that the uptake of routine adult vaccines such as influenza, pneumococcal, hepatitis B, and diphtheria-tetanus-pertussis (DTP) remains abysmally low, often below 2% or 3%. While COVID-19 vaccine coverage for the first two doses was impressive among the elderly, booster uptake significantly lagged, reaching only 33% by mid-December 2022 for those aged 60 and above. This underutilization is largely attributed to the absence of a structured national adult immunisation program, making adult vaccination niche, opportunistic, and clinician-driven. Older adults, particularly those with comorbidities, face increased susceptibility to severe infections and higher mortality rates due to immunosenescence, the age-related decline of the immune system. Studies reveal significant disparities in vaccine uptake, with affluent groups and individuals with certain chronic conditions showing slightly higher, though still low, coverage. To address this, experts call for immediate policy intervention, advocating for the integration of adult vaccination into primary care and geriatric services, community-based campaigns to reduce access barriers, enhanced clinician training, and robust epidemiological data generation to guide tailored vaccine policies. Such measures are crucial to improve healthy ageing and reduce the burden of vaccine-preventable diseases in India.