By Ethan Covey
Vaccination against COVID-19, influenza and respiratory syncytial virus (RSV) remains low in the United States, and is particularly low for updated COVID-19 and RSV vaccines, according to a CDC report (MMWR Morb Mortal Wkly Rep 2023;72[51]:1377-1382).
“Clinicians should make a strong recommendation for routinely recommended vaccines, that is, the updated COVID-19 and flu vaccines, and engage in shared clinical decision making about RSV vaccination with older adults,” said Carla L. Black, PhD, an epidemiologist with the CDC.
The CDC examined survey data about receipt of COVID-19, flu and RSV vaccines; intent for vaccination; sociodemographic characteristics; and behavioral and social drivers of COVID-19 vaccination.
The study found that as of Dec. 9, 2023, flu and COVID-19 vaccination among U.S. adults is low, with only 42% of American adults having received the 2023-2024 flu vaccine and 18% of American adults who are 18 years of age and older having received the updated (2023-2024) COVID-19 vaccine. In addition, RSV vaccination coverage among adults who are at least 60 years was 17%.
“[This shows] that there are continued opportunities to improve uptake of RSV vaccine,” Dr. Black said.
Approximately 41% of all adults and 53% of adults 60 and older were unvaccinated but reported that they definitely or probably plan to receive, or are unsure about receiving, the updated COVID-19 and RSV vaccines, respectively. This, the study authors wrote, suggests that they are open to vaccination.
“While coverage is lower than we’d like to see, people reported intent to be vaccinated with these vaccines, and there is still time to do so during this respiratory virus season,” Dr. Black noted.
“Vaccination is a keyway to prevent severe disease, hospitalization and death from flu, COVID-19 and RSV.”
She added that other surveys found that people who intend to get the flu or COVID-19 vaccine report not having done so primarily due to lack of time, or not having gotten around to it.
“There is less of a concern with getting sick with flu or COVID [than there was in previous years],” Dr. Black said.
“For COVID, people still report concerns about unknown long-term side effects from the vaccine,” she continued. “However, numerous studies have shown that COVID-19 vaccines are safe and effective.”
Reported barriers to vaccination for RSV often highlighted a lack of a provider recommendation and not lack of knowledge about RSV or the RSV vaccine.
“CDC provides resources to healthcare providers to help educate their patients on the need for vaccination and provide data to support the safety and effectiveness of vaccinations,” Dr. Black said.
A second report, which focused on use of the same vaccines among nursing home residents, found that while influenza vaccine coverage was relatively high, rates for COVID-19 and RSV vaccination were low (MMWR Morb Mortal Wkly Rep 2023;72[51]:1371-1376).
As of Dec. 10, 2023, 33% of nursing home residents were up to date with COVID-19 vaccination. Among the facilities that reported influenza and RSV vaccination coverage, 72% of residents had received the influenza vaccine and 10% had received the RSV vaccine.
“Fall 2023 is the first season that vaccines were available to protect older adults in the U.S. against all three respiratory illnesses: COVID-19, flu and RSV,” said Hannah E. Reses, MPH, an epidemiologist and lead for the CDC’s Vaccination Unit in the Division of Healthcare Quality Promotion. “There is an urgent need to protect nursing home residents against severe outcomes of respiratory illnesses by increasing vaccination against COVID-19 and flu and discussing RSV vaccination with eligible residents.”
Ms. Reses noted that clinicians can do their part by offering recommended vaccinations to residents.
“Nursing homes are encouraged to collaborate with state, local and federal public health, and long-term care pharmacy partners to address barriers contributing to low vaccination coverage,” she said. “Getting vaccinated protects people from the potentially serious consequences of flu, COVID-19 and RSV, including hospitalization and death.”
Ms. Reses reported no relevant financial disclosures.
