Although this year's flu season could be challenging, fewer adults have been vaccinated against influenza, a new study shows.
Much less than half of US adults have been immunized against any respiratory virus, according to a survey of 1,015 adults released this week by the National Foundation for Infectious Diseases (NFID).
Just 34% of adults have gotten a flu shot; 25% have had a COVID-19 shot; 8% have received a vaccine to prevent pneumococcal disease, caused by bacteria that can lead to pneumonia, meningitis, and sepsis; and 6% have been vaccinated against respiratory syncytial (RSV), a leading cause of hospitalization in infants and older adults.
New data from IQVIA, which provides health care statistics, show similar declines over the past year. Retail pharmacies have seen falling numbers of vaccinations for three major respiratory viruses:
- 34% decline in RSV vaccinations
- 27% drop in COVID-19 vaccinations
- 6% reduction in flu shots
Pneumococcal vaccinations are the one bright spot in IQVIA's data, with vaccinations rising 27% in the past year. The uptick is likely due to the Centers for Disease Control and Prevention's (CDC’s) decision last year to lower the age at which people are eligible for pneumococcal vaccine from 65 to 50, said Robert Hopkins, NFID's medical director.
The NFID survey, conducted online November 10 to November 12, asked people why they're hesitant about vaccination.
Among those who haven't received a flu shot, 16% said they were worried about safety, while 13% said they “never get sick." For COVID-19, 20% worried about side effects and 12% said no healthcare professional has recommended vaccination
Differing views on vaccines by age, political party
The survey also sheds light on where people get their information on vaccination.
About 44% of people said that they trust their health care provider more than anyone else to provide vaccine information; only 13% of all respondents listed the CDC as their top source.
Younger generations are less likely be guided by public health institutions and more likely to look to their phones. Fifteen percent of Gen Z adults (ages 18 to 28) rank social media as their second most-trusted source of vaccine information.
The poll also found political differences about vaccination.
Democrats were more likely than Republicans or Independents to receive an updated flu or COVID-19 shot. Forty-one percent of Democrats received a recent flu shot, compared with 35% of Republicans and 22% of Independents. Thirty-four percent of Democrats received an updated COVID-19 shot, compared with 20% of Republicans and 19% of Independents.
‘Historic low levels of trust’ could be deadly
"We're seeing historic low levels of trust in public health, and that is potentially deadly, " said Tom Frieden, MD, MPH, former CDC director and founder and CEO of Resolve to Save Lives, a global public health organization, at a December 3 webinar on seasonal viruses that was organized by NFID.
Public health experts have struggled to deal with the "firehose of falsehoods" from anti-vaccine activists, Frieden said. He recommended that public health agencies make better use of social media and work with online influencers to provide accurate information.
"I think the way we rebuild trust is by listening well, by communicating well, by identifying the right messages and messengers, by being clear about what we know and what we don't know," Frieden said. "Science doesn't give certainty. Science gives humility."
We're seeing historic low levels of trust in public health, and that is potentially deadly.
Much of the erosion in trust in public health organizations has been created by the Trump administration, which has spread false information about vaccines, said Rochelle Walensky, MD, MPH, also a former CDC director who spoke at the webinar.
Mainstream health care providers, medical societies, and hospitals "have actually been singing with a continuous, unified voice" about vaccine safety, said Walensky a professor at Harvard University. "The thing that has been divergent, very sadly, I think, over the last several months, has been not the medical societies and your providers, but in fact, the US government."
A spokesperson for the Department of Health and Human Services did not respond to a request for comment by deadline.
Confusion over changed guidance
The Trump administration has changed the recommendations for several vaccines. For example, instead of recommending COVID-19 shots for everyone over age 6 months, the CDC now says that people should make a decision after talking with their health care provider.
In September, the CDC recommended breaking the MMRV vaccine, which protects against measles, mumps, rubella and varicella, or chickenpox, into two shots. The CDC now says that children should receive one shot to prevent chickenpox and a separate shot (the MMR vaccine) to prevent measles, mumps and rubella.
Against that backdrop, 44% of those polled in the NFID survey found guidance on respiratory vaccinations either unclear or neither clear nor unclear.
A poll published by the Pew Research Center last month found that most Americans say they either aren't aware of changing vaccine advice or that the changes haven't influenced their behavior.
In another Pew survey from November, nearly two-thirds of respondents reported high confidence in vaccine effectiveness, while about half trust their safety testing and schedule.
The NFID recommends these vaccinations to prevent respiratory illnesses:
- Annual flu vaccination for everyone age 6 months and older.
- COVID-19 vaccination for those at high risk (including young children, pregnant women, older adults, and people with chronic health conditions), and anyone age 6 months and older who wants to be vaccinated against COVID-19.
- RSV vaccination for pregnant women or RSV immunization (monoclonal antibody) for infants whose mothers did not receive an RSV vaccine during pregnancy; RSV vaccination for certain adults age 50 to 74 and all adults age 75 and older.
- Pneumococcal vaccination for children younger than age 5 years, all adults age 50 years and older, and people with certain chronic health conditions or other risk factors.
