Flu, Covid vaccination rates decline, as U.S. health officials make new push for inoculations

Vaccination rates against flu and Covid-19 have declined since earlier in the pandemic and a new survey suggests significant portions of the U.S. population intend to forgo these vaccines this fall.

The survey, conducted by the National Foundation for Infectious Diseases, suggests only about one in five Americans worry that they or someone in their family will contract influenza, Covid, or RSV — respiratory syncytial virus.

About 43% of U.S. adults said they didn’t intend to get a flu shot or were uncertain about whether they would get one. Only 40% plan to get an updated Covid shot and only 40% of eligible adults — those aged 60 or older — plan to get one of the new RSV jabs.

The data were presented at an online press conference attended by the director of the Centers for Disease Control and Prevention, Mandy Cohen, who stressed that she, her children and husband, and her parents would be getting all the vaccinations for which they are eligible.

“As a mom, as a wife, as a daughter, I wouldn’t recommend something for the American people that I wouldn’t recommend to my own family,” Cohen said.

“It’s exciting we have these tools. We need to use them.”

With Covid transmission surging and flu and RSV seasons on the near horizon, federal officials have been keen to project that this fall and winter’s respiratory disease season won’t be a repeat of last year’s chaotic activity, when the early arrival of RSV and influenza coincided with an increase in Covid transmission to strain health care capacity across the country.

But their efforts have been undermined by a bumpy rollout of updated Covid vaccines, which this fall for the first time are being provided by the commercial market. The shift from a single payer — the federal government — to a wide array of private and public payers, plus changes in the delivery system, have led to reports of people struggling to find vaccination appointments or being informed that their appointment was canceled because the pharmacy or physician’s office did not receive adequate supplies of vaccine.

In other cases, some people learned at vaccination appointments that their health insurance had not yet taken the internal steps necessary to start covering Covid shots, leaving them with the choice of having to pay out-of-pocket or rescheduling the appointment.

Health and Human Services Secretary Xavier Becerra met Wednesday with major health insurance providers to press them on the problems. According to a report on the meeting from HHS, the industry representatives assured Becerra that the coverage problems have been largely resolved.

The reasons survey respondents gave when asked why they didn’t plan to get vaccinated were not, however, related to access. Instead they cited concerns about side effects, distrust in vaccines, or the belief the vaccines did not work well.

“As healthcare professionals, we need to address these unfounded concerns and create realistic expectations about what vaccines can and cannot do,” said Patsy Stinchfield, president of the National Foundation for Infectious Diseases. “Even in cases when vaccination does not prevent infection entirely, getting vaccinated can help protect against serious complications, including hospitalization and death.”

Rebuilding confidence in vaccines is critical, said Robert Hopkins, the foundation’s medical director.

“We’ve got tools that we can use to help protect families, help individuals to be protected. But if we don’t rebuild vaccine confidence, as we start this flu season we’re really missing an opportunity to save lives, to save productive work time, to save time for people to spend with other members of their family,” Hopkins said.

New data from the CDC showed that in 2022-23, flu vaccination rates among children, pregnant people, and health care providers dropped 6%, 15%, and 5% respectively, as compared to 2019-2020, the last flu season before the Covid pandemic, said Cohen.

During the past season, which CDC characterized as “moderately severe,” an estimated 14 million people sought health care for flu, 360,000 were hospitalized because of flu, and there were roughly 21,000 flu-related deaths.

Correction: A previous version of this article stated the decline in flu vaccination rates was in comparison to 2021-22 rates. It also erroneously stated that 97% of people hospitalized with flu in 2022-23 were unvaccinated.