Decline in Receipt of Vaccines by Medicare Beneficiaries During the COVID-19 Pandemic — United States, 2020

Hong, Kai; Zhou, Fangjun; Tsai, Yuping; Jatlaoui, Tara C.; Acosta, Anna M.; Dooling, Kathleen; Kobayashi, Miwako; Lindley, Megan C.

doi:10.15585/mmwr.mm7007a4

Cited by 26 publications

(15 citation statements)

References 5 publications

(2 reference statements)

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“…Our study provides valuable data through the last decade and into the first 6 months of the ongoing COVID-19 pandemic, which may also inform future research into the impact of pandemics on immunization rates. Although motivation to receive the influenza vaccine may have increased during the COVID-19 pandemic [ 38 ], coverage of many other vaccines has been negatively impacted by the pandemic, among both adults and children [ 39 , 40 ]. Similarly, it is likely that adherence and completion rates for multi-dose hepatitis vaccines have decreased during the COVID-19 pandemic, especially among high-risk individuals who are probably even more susceptible to pandemic-related challenges in seeking healthcare than they are under more conventional circumstances [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Hepatitis vaccination adherence and completion rates and factors associated with low compliance: A claims-based analysis of U.S. adults

et al. 2022

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Poor compliance with multi-dose vaccine schedules by adults for whom hepatitis (Hep) A and B vaccines are recommended contributes to major Hep A and B disease burdens among high-risk U.S. adults. Evidence on hepatitis vaccine series adherence, completion, timeliness of completion, and factors associated with these outcomes, is limited and not readily generalizable for U.S. adults. This retrospective, observational study examined adherence, completion, its timeliness, and the impact of sociodemographic and clinical factors on these outcomes among a large, geographically representative sample of U.S. adults. We analyzed the Optum Clinformatics SES administrative claims database (1/1/2010-6/30/2020) for recipients of 2-dose (HepA, HepB2) or 3-dose (HepB3, HepAB) hepatitis vaccines. Adherence was defined as receipt of booster doses within specified assessment periods, per label-recommended schedules. Completion (receipt of all doses) was assessed at 6, 12, 18, and 24 months.The study included 356,828 adults ≥19 years old who were continuously enrolled in a medical benefit plan for one (HepB2), six (HepB3; HepAB), or 18 months (HepA) prior to and following the index date (first observed vaccine dose). Adherence and 24-month completion rates were: HepA (27.0%, 28.4%), HepB2 (32.2%, 44.8%), HepB3 (14.3%, 37.3%), HepAB, (15.3%, 33.8%). Kaplan-Meier completion curves plateaued after about 6 months for HepB2 and about 12 months for HepA, HepB3, and HepAB vaccines. Logistic regression analyses showed risk for low adherence/completion was generally associated with male gender, younger age, Black or Hispanic race/ethnicity, lower educational or household income attainment, and more comorbidities. Adherence and completion rates for all hepatitis vaccine series are low, especially for males, younger adults, those with lower socio-economic status and more comorbidities. To our knowledge, this is the largest claims-based analysis of adherence and completion rates for U.S. adults initiating all currently available HepA and HepB vaccines. Findings may inform hepatitis vaccination programming.

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Section: Discussionmentioning

confidence: 99%

Hepatitis vaccination adherence and completion rates and factors associated with low compliance: A claims-based analysis of U.S. adults

et al. 2022

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“…The coronavirus disease 2019 (COVID-19) pandemic has led to significant declines in the administration of routinely recommended vaccines in the US [1][2][3][4][5]. Public health agencies and authorities have raised concerns over deficits in routine vaccination rates due to the pandemic, including the potential shortand long-term public health implications [6].…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on adolescent vaccinations: projected time to reverse deficits in routine adolescent vaccination in the United States

Saxena

Marden

Carias

et al. 2021

Current Medical Research and Opinion

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Objective: The COVID-19 pandemic has led to significant reductions in the administration of routinely recommended vaccines among adolescents in the US including tetanus, diphtheria, and acellular pertussis (Tdap); meningococcal (ACWY); and human papillomavirus (HPV) vaccines. The extent to which these deficits could persist in 2021 and beyond is unclear. To address this knowledge gap, this study estimated the cumulative deficits of routine vaccine doses among US adolescents during the COVID-19 pandemic, and estimated the time and effort needed to recover from those deficits. Methods: Monthly reductions in Tdap, meningococcal, and HPV doses administered to US adolescents during the COVID-19 pandemic were quantified using MarketScan Commercial Claims and Encounters data. The time and effort required to reverse the vaccination deficit under various catch-up scenarios were estimated.Results: Annual doses administered of Tdap, meningococcus, and HPV vaccines decreased by 21.2%, 20.8%, and 24.0%, respectively, in 2020 compared to 2019. For 2021, the reduction in doses administered is projected to be 6%-21% compared to 2019 under different scenarios. The deficit of missed doses is expected to be cleared between winter 2023 and fall 2031. Conclusions: Administration rates of routine vaccines decreased significantly among US adolescents during COVID-19. Reversing these deficits to mitigate long-term health and economic consequences will require a sustained increase in vaccination rates over multiple years.

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“…For the 185 (68.0%) participants who were unvaccinated and undecided, not interested, or only “somewhat” interested in vaccination, the most frequently reported reasons were concern about side effects ( n = 71, 38.4%), no vaccine recommendation from a physician or nurse ( n = 67, 36.2%), not knowing enough about the vaccine ( n = 58, 31.4%), concern it could cause HZ ( n = 41, 22.2%), and that “no one else” had recommended it ( n = 33, 17.8%) ( Figure S1 ). The recent COVID-19 pandemic has been reported to impact overall vaccine receipt and hesitancy [ 36 ], but almost all participants in this study reported that the pandemic had not changed ( n = 543, 73.9%) or had increased ( n = 169, 23.0%) their interest in receiving HZ vaccination; only 23 (3.1%) participants stated that the pandemic had decreased their interest.…”

Section: Resultsmentioning

confidence: 78%

Knowledge and Attitudes Concerning Herpes Zoster among People with COPD: An Interventional Survey Study

et al. 2022

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Herpes zoster (HZ) is common in older adults with conditions such as chronic obstructive pulmonary disease (COPD). Effective prevention is available through vaccination, but HZ vaccine uptake remains incomplete. Using an online survey of people with self-reported COPD, ShiPPS assessed HZ risk awareness, HZ vaccine use and barriers, and the impact of an HZ educational video on vaccine intent. USA members of the COPD Foundation’s Patient-Powered Research Network aged >50 years were surveyed in fall 2020. The responses were analyzed using descriptive and comparative statistics. Of the 735 respondents (59.6% female, mean age 68.5 years), 192 (26.1%) reported previous HZ, of whom 49 (25.5%) reported increased COPD symptoms during HZ episodes. Most participants (94.0%) knew of HZ vaccines, but only 33.1% reported receiving the Advisory Committee on Immunization Practices-preferred recombinant HZ vaccination. The recall of receiving HZ vaccine recommendations differed by the site attended: 68.8% primary care, 26.6% pulmonology offices. Most (74.7%) were unaware that COPD increases HZ risk. Among unvaccinated participants, interest in getting the HZ vaccine increased from 32.0% to 73.5% after watching the video. These results highlight the need for people with COPD to receive further HZ education, such as the five-minute video, and HZ vaccine recommendations from healthcare professionals.

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Decline in Receipt of Vaccines by Medicare Beneficiaries During the COVID-19 Pandemic — United States, 2020

Cited by 26 publications

References 5 publications

Hepatitis vaccination adherence and completion rates and factors associated with low compliance: A claims-based analysis of U.S. adults

Hepatitis vaccination adherence and completion rates and factors associated with low compliance: A claims-based analysis of U.S. adults

Impact of the COVID-19 pandemic on adolescent vaccinations: projected time to reverse deficits in routine adolescent vaccination in the United States

Knowledge and Attitudes Concerning Herpes Zoster among People with COPD: An Interventional Survey Study

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