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Pharmacy Update: Declining Vaccination Administration Rates-Opportunity to Rebuild Trust

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Vaccinations have been one of the main buzzwords used during the COVID-19 pandemic. For perhaps the first time in modern history, the general public received overwhelming amounts of vaccination information that changed in a moment’s notice. The influx and variation of information have left many questioning the validity and source of content pertaining to vaccinations. Even now patients are seeking clarity of information, especially when it comes to vaccination eligibility and vaccination duration/scheduling.

As we continue to navigate the unexpected vaccine landscape it is imperative that we reset, re-educate and rebuild any trust that may have been lost during the pandemic. The recommended best place to start is to recapture any immunity that was lost. During the pandemic, gaps of immunity were created due to the decrease in adult immunization rates. According to CDC data, the most significant decrease in vaccination rates occurred in the following three adult vaccinations: influenza, pneumococcal, and zoster. 

Influenza can be associated with hospitalizations, serious illnesses, and sometimes death. In 2021 and 2022, relatively low rates of influenza cases occurred. Many experts contributed this phenomenon to all the mask wearing and social distancing during this time. In addition to the decline in influenza cases was the decline in influenza vaccination rates, which may have inadvertently caused many to lose built-up immunity to the virus. With the “twindemic” (COVID-19 and influenza) swiftly approaching, it is imperative to recapture and re-educate on the importance of not only getting a flu shot, but also when to receive, along with the recommended type. For example, patients who are 65 years and older should receive the high dose flu vaccine versus the regular dose. In addition, patients with no preexisting conditions should be encouraged to take the influenza vaccination later in the year due its protection only lasting 4-6 months.

Similar to influenza vaccine rates, pneumococcal and zoster rates also declined as a result of the pandemic. During the pandemic the elderly population was considered a high risk group, and as a result, the majority of focus shifted to ensuring they received COVID-19 vaccinations and not much else. Pneumococcal disease can have variation in symptoms depending on the part of the body that is infected. Although the majority of pneumococcal infections are mild, some can be deadly and result in long term problems. The CDC recommends routine administration of the pneumococcal for all adults 65 and older. Herpes zoster, is a disease caused by the reactivation of the varicella zoster virus. Shingles can lead to painful blister rashes and chronic pain. The CDC recommends two doses of recombinant zoster vaccine in adults 50 years and older. Since vaccines are the best way to prevent both pneumococcal disease and herpes zoster, it is important to refocus and relaunch the vaccine initiatives among this patient population.

Vaccinations will continue to be a buzz word in the foreseeable future. Now that we are on the downward slope of the pandemic, the time has come to reset, recapture and regain any vaccinations that may have been missed. In addition, there is now a tremendous need/opportunity to re-focus and rebuild trust through education and awareness. If we do not learn from history, we are often doomed to repeat it. As health care professionals, it is imperative that we start the conversation, incorporate the lessons learned and rebuild in preparation for things yet to come to ensure the safety of our community and patients.


  1. Recommended adult immunization schedule for ages 19 years or older, United States 2022. Centers for Disease Control and Prevention. Reviewed February 17, 2022. Accessed June 22, 2022.
  2.   Accessed September 6, 2022
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