Covid vaccine rates are falling in the US

Covid vaccine rates are falling in the US

  • Uptake of Covid doses is declining, and vaccine makers and health experts believe vaccination rates in 2024 and beyond will likely look similar to uptake in the last round of vaccinations this year.
  • The biggest uncertainty seems to be whether rates could rise in the future — and what might prompt more people to roll up their sleeves.
  • What experts and vaccine makers can agree on is that lower vaccination rates are putting more people at risk of severe Covid infection.

A banner advertising COVID vaccine doses at a Walgreens pharmacy in Somerville, Massachusetts, on August 14, 2023.

Brian Snyder | Reuters

Three years into the COVID-19 pandemic, few Americans have rolled up their sleeves to get a COVID-19 vaccine.

Only 15.7% of US adults had received the latest COVID-19 vaccines from Pfizer, Moderna and Novavax as of November 18, according to the latest data from the Centers for Disease Control and Prevention. These vaccines, some of which received approval in mid-September, are designed to target the sub-omicron variant XBB.1.5.

“Here is the bottom line: COVID-19 vaccine uptake is lower than we would like to see, and most people will be without additional protection that could reduce the severity of COVID-19,” the CDC wrote in an update on its website. last week.

Some vaccine makers and health experts believe U.S. coronavirus vaccination rates in 2024 and beyond will likely look similar to the paltry uptake of the last round of vaccinations in the fall and winter.

The biggest uncertainty seems to be whether rates could rise in the future — and what might prompt more people to roll up their sleeves.

Some experts hope that a new, more convenient list of doses that target more than one respiratory virus will boost Covid vaccinations. But others are more skeptical about whether these combination injections will make a difference.

Experts and vaccine makers can agree that declining coronavirus vaccination rates are concerning, even as cases of the virus dwindle from their pandemic highs.

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Vaccines remain a critical tool to protect people from dying or being hospitalized from Covid, which is still killing Americans every day. Reducing doses could leave many people — especially older adults and those with underlying medical conditions — vulnerable to severe infections.

Low vaccination rates also make the United States less prepared if a new, more worrisome variant of the virus emerges and leads to another surge in cases and hospitalizations, added Dr. Ali Mokdad, an epidemiologist and chief population health strategy officer at the University of Washington.

Uptake of Covid vaccines has waned since the first vaccines against the virus were rolled out in late 2020, when Americans felt an urgent need to protect themselves as cases rose.

This year, nearly half of previously vaccinated adults said not worrying about Covid was the reason they didn’t get a new vaccine, including a quarter who called it a “top reason,” according to a poll released earlier this year. Monthly published by health policy research organization KFF.

This logic reflects multiple factors. First, Covid infections have not risen significantly in the United States this year, especially compared to years prior to the pandemic, according to Mokdad.

He added that people have greater immunity from vaccinations or previous infections, which protects them from becoming severely ill from the virus. The data also suggests that Omicron variants, the predominant Covid strains circulating in the United States, tend to be less dangerous than some other strains. Al-Miqdad added that previous versions.

“People say, ‘I get it, and it didn’t really hurt me. So why do I need to go and get a vaccine?'” Mokdad said.

The new COMIRNATY® (Covid-19 vaccine, mRNA) vaccine from Pfizer is available at CVS Pharmacy in Eagle Rock, California.

Irfan Khan | Los Angeles Times | Getty Images

Nearly 4 in 10 adults also said they were too busy to get the new Covid vaccine, according to the KFF poll.

Some Americans may not be accustomed to treating their coronavirus vaccination as a “routine activity” for their health each year, according to Jennifer Cates, senior vice president of the KFF Foundation.

Others may not prioritize COVID vaccines because they are confused about the levels of risk and benefits they personally will see from another booster shot, added Dr. Brad Bullock, chair of the Department of Public Health Sciences at UC Davis Health.

Moreover, a group of Americans may never get COVID vaccines because they remain skeptical about their safety and effectiveness.

Political polarization has exacerbated this effect: Republicans have become increasingly hostile toward the shots, with some even fueling conspiracy theories and misinformation about getting vaccinated.

Only 23% of Republican respondents to the KFF poll said they have gotten or will get the latest coronavirus vaccine this fall or winter, compared with 40% of independents and 74% of Democrats.

The lack of urgency around Covid could impact uptake in the coming years, said Dr. Nicole Iovine, the hospital’s chief epidemiologist and an infectious disease physician at the University of Florida.

But she noted that people who get the new Covid vaccine this fall are likely to get future iterations. “There is definitely a core group of people who will always get their vaccine,” Iovine said.

Jefferies analyst Michael Yee specifically noted that patients at high risk for severe Covid who are open to vaccination “would be reasonable” to take it every year.

Most Covid vaccine makers themselves assume that vaccine uptake in 2024 and beyond may look similar to what the United States sees this fall and winter.

“So, we assume things will be the same in the coming years, Covid fatigue, anti-vaccination rates, so people who did it this year will continue to do so next year,” Pfizer CEO Albert Bourla said during a phone call. “. With investors in mid-October. “I think it’s a perfectly safe assumption.”

Likewise, Moderna assumes that everyone who got a Covid vaccine in 2023 will “at least” get a Covid vaccine in 2024 and beyond, Moderna Chief Commercial Officer Arpa Garay said during the company’s third-quarter earnings call last month. Garay also said the company expects about 50 million Americans to get a new vaccine between September and December of this year.

John Trizzino, Novavax’s chief operating officer, told CNBC there is “logic and reality” to Pfizer and Moderna’s expectations. But he said 2023 would not be a “100% indicator” of future vaccination rates, especially since the vaccine rollout this year was an “adjustment period” for the commercial market with delays in distribution.

Trizino also said combination doses targeting Covid and other viruses, including the Novavax virus, will likely hit the market within a few years, which could augment Covid vaccinations in the US.

Pfizer, Moderna and some experts agree that combination doses could increase Covid vaccination rates by providing more relief to patients and health care workers.

“I think it’s going to really help. More Americans are getting the flu shot and the COVID vaccine together, which will increase the number of people getting the COVID vaccine over time because it’s more accessible from a convenience standpoint for anyone, as well as the technical aspect of management,” the CFO said. Moderna’s Jamey Mock in an interview earlier this month.

But other experts are more skeptical about whether these vaccines will have a noticeable effect.

The three companies are developing vaccines targeting different combinations of coronavirus, influenza and respiratory syncytial virus, which collectively strained the U.S. health care system last winter and could continue to peak around the same time each year.

The companies have released positive mid-stage trial data on some of their combination doses this year, and expect their vaccines to receive US regulatory approval in 2025 and 2026.

Vaccine bottles in a medical clinic.

Engelb | iStock | Getty Images

Combination vaccines are not new: Children’s vaccines have long been combined to eliminate extra trips to the doctor’s office and reduce the number of injections a patient needs to get during their visit. This approach could lead to fewer wasted doses and higher vaccination rates for the diseases they target, according to Andrew Piekosh, a professor at the Johns Hopkins Bloomberg School of Public Health.

Other studies also suggest that combining vaccines targeting Covid and influenza in particular could boost Covid vaccination rates, which lag behind flu vaccination rates this year.

More people are accustomed to receiving flu vaccines annually, so they may “find it easier to replicate such a health measure in the case of combination doses” targeting Covid and influenza, according to a 2023 study that analyzed 30 different research papers on the vaccine approach. .

However, the University of Florida’s Iovine doesn’t believe the combination doses will have a significant impact on Covid vaccination rates.

While the jabs may be attractive to people who have already gotten their shots or those who are looking for them And with more convenient vaccination options, they may do little to change the minds of people who avoid the Covid vaccine for reasons such as skepticism or concerns about safety and effectiveness.

Likewise, Yi, the Jefferies analyst, said he doesn’t think “convenience will be the differentiating factor” in determining whether someone gets a Covid vaccine, which is why combination doses may not “materially change” uptake.

He added that some people still worry about whether combination vaccines cause more side effects than standalone vaccines. Pfizer, Moderna and Novavax have not reported significant differences between side effects of their combination vaccines and existing doses, but more data is needed.

If combination shots don’t work, it’s unclear what could boost coronavirus vaccination rates in the future.

Iovine said people may feel greater urgency to get vaccinated if a new, more worrisome variant of Covid emerges and leads to another wave of cases. But even during previous Covid waves, “the country did not see a massive uptake of vaccines,” according to Iovine.

Pharmacist Aaron Sun administers the new COMIRNATY® (Covid-19 vaccine, mRNA) vaccine from Pfizer, to John Foetsch at a CVS Pharmacy in Eagle Rock, California.

Irfan Khan | Los Angeles Times | Getty Images

Meanwhile, KFF’s Kates said public health officials and providers may increase uptake if they clearly communicate that Covid vaccines will likely be a “routine part of health care” going forward.

The FDA and CDC hope to move toward a flu shot-like model for Covid vaccines, meaning people would get one dose each year that would be updated annually to target the newest variant expected to spread in the fall and winter.

But FDA advisers have raised concerns about the shift to annual Covid vaccines, noting that it is unclear whether the virus is seasonal like the flu. Cates added that establishing a more annual approach to Covid vaccination in the minds of Americans “will take time.”

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