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Vaccination Rates Affected by Vaccine Hesitancy and Fatigue


James Lewis, PharmD, FIDSA, opens a discussion regarding the current and anticipated landscape surrounding vaccination.

James Lewis, PharmD, FIDSA: Since the onset of the COVID-19 pandemic, vaccine hesitancy has become more of an issue. Unfortunately, we’ve seen the expansion of not only the usual hesitancy from a scientific side but also a political mix, which is complicating things. Overall, this has created significant challenges for health care providers and vaccine manufacturers about how best to message this to ensure that we optimize vaccine uptake. It complicates what was already a complicated issue. A lot of the strategies that we’ve tried in the past continue to be extremely important—honest, frank, straightforward, clear conversations from trusted health care providers. This can’t mean only physicians. This has to mean nurse practitioners, pharmacists, and nurses on the front line, who all become key in this messaging.

We’ve seen a disturbing rise in health care providers who are expressing vaccine hesitancy as well. From a professional organization standpoint, it’s extremely important to continue pushing out high-quality education to ensure that our health care providers are extremely well educated as well. All of these have to be in place so that when patients have questions, they can ask individuals they trust and receive honest, clear, straightforward messaging that’s consistent with best health care practices.

Regarding whether certain patient age groups have struggled with regard to making sure that they’re getting their recommended vaccines, I have to admit to being part of the group that I see the most commonly struggle with this: healthy middle-aged adults over the age of 50, who are supposed to get Shingrix [vaccine used for the prevention of shingles]…. I’ve been dragging my feet on getting my Shingrix, which makes no sense because I’ve seen individuals with shingles, and it’s miserable. Why didn’t I run in there and do it? I’m busy. I’ve got commitments with work and family. The other thing that differs in the adult space is that children, who receive the vast majority of vaccines, have regularly scheduled doctor checkups. That’s a huge difference between the pediatric population and the adult population. Particularly in a healthier younger adult population—say, 50 to 65 [years old], who may not have a lot of medical comorbidities. That’s a challenging group to hit.

We need to develop a different structure. The reason the pediatric population works so well is because pediatricians and parents are used to this. It’s part of the regular clinical practice, part of the regular 3-, 6-, 9-, or 12-month checkups. With adult patients, we in the US health care system do a lousy job. I had 2 doctor’s appointments yesterday—no joke. I’m not making this up—and neither mentioned that I was late for my Shingrix vaccine and my hepatitis B vaccine. We in the health care system are part of the problem. We need to think about better ways to make sure we’re messaging patients: “You’re due for this. Did you know about this?” No one has said a word to me about Shingrix, even though it’s been a year since I was supposed to have received that vaccine. I don’t think that’s a failure on the patient’s side. That’s a failure on the health care provider’s side. It’s the system that we use for providers to remind adults like me, “You’re due for this.” If you said that to me, and I was sitting there in the doctor’s office, I sure as heck would say, “Go ahead, hit me.” But nobody said it yesterday, and I had 2 doctor’s appointments. Enough said.

Transcript edited for clarity.

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