Emerging From the Pandemic, a Stark Vaccine Deficit Is Revealed

As we begin to come out of the COVID-19 pandemic, things are starting to get back to normal in many areas — with at least one notable exception. Millions of children, teens and adults have missed doses of recommended vaccines that would protect them from illness, putting them at risk as they return to activities after being protected through immunization from COVID-19.

A new report released by the US Centers for Disease Control and Prevention looked at 10 U.S. jurisdictions and found a “substantial decrease” in routine childhood and adolescent vaccinations and warned of the potential “public health threat, resulting in vaccine-preventable disease outbreaks, especially as schools reopen for in-person learning.”

The focus of a study commissioned by GSK and recently published by Avalere Health likewise reported a dramatic drop in non-COVID-19 vaccinations. It noted a significant drop in the uptake of vaccines recommended for teens and adults that occurred in March and April 2020, when pandemic lockdowns began, compared to the same months in 2019. It also showed the vaccine deficit persisted through the first 11 months of 2020. Specifically, the new data shows:

• Teens and adults missed more than 26 million doses of recommended vaccines in 2020. This includes 8.8 million missed adolescent vaccine doses and 17.2 million missed adult vaccine doses.
• Vaccine claims among teens and adults fell up to 40 percent. Total non-influenza vaccine claims submissions were between 13-40 percent lower than the same period in 2019.
• Despite warnings of a potential “twindemic,” influenza immunization rates were actually lower in 2020 than in 2019.

The drop in adult rates is particularly alarming as vaccines in this population were already underutilized before the pandemic. Despite more than a decade of work by industry and public health stakeholders to tackle this problem, our country still lacks a consistent, coordinated and comprehensive adult immunization infrastructure.

Why It Matters

History shows us what happens when individuals go unprotected against infectious and debilitating disease. For example, from 2016 through May 2021, states reported 39,488 cases of hepatitis A to the CDC, and in 2014-15, a measles outbreak linked to exposures at the Disney theme parks in California sickened 147 people, most of them unvaccinated. The CDC in 2019 tallied 1,282 measles cases in 31 states.

Measles is only one of the dangers. Missed vaccinations raise the risk of debilitating diseases, such as shingles, pneumococcal disease, HPV and others. These are largely preventable with vaccination. By skipping recommended shots, people leave themselves vulnerable to severe illness, missed work and days out of school, while also adding to the stress on hospitals and health care systems still struggling to recover from the COVID-19 pandemic.

The Avalere Health paper notes that while there had been “incremental improvements’’ in vaccine rates just after the steeper declines at the onset of the pandemic in spring 2020, “these improvements leveled off and stagnated through the fall, particularly in the adult population, as lockdowns and the pandemic persisted.’’

This has led to a snowball effect: “Missed vaccine doses have accumulated throughout the pandemic, while utilization remains well below 2019 levels. As such, this vaccination deficit is likely to continue to grow, particularly as the US saw a significant rise of COVID-19 cases after November 2020.’’

There is some reason for optimism. As more people seek routine health care, the CDC, which initially advised against administering the COVID-19 vaccine within a two-week window of other vaccines being given, has revised that recommendation and currently says COVID-19 vaccines and other vaccines may now be administered without regard to timing. This should simplify catch-up for patients and health care professionals, particularly as we approach back-to-school and influenza season.

The speed and success of the COVID-19 vaccine rollout stunningly illustrates what can be accomplished when the government, public health, advocacy groups and the private sector work together. Similarly, we need a concerted effort led by trusted messengers – health care professionals, community leaders, grassroots advocates and government officials – to bring everyone up to date on all the other vaccines they need to stay strong and involved in work, school and daily life.

COVID-19 has taught us the power of vaccines in preventing disease. We must urgently work together to close the gap on missed vaccines. An immunized population is the safest and most effective way to keep individuals and communities healthy in the months to come.

Judy Stewart is senior vice president and head of U.S. vaccines at GSK.

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