Fall 2023 vaccine coverage and reaching "passive positives"

Our piece in Scientific American

We are approaching the end of October, and at least 10 million Americans have gotten the Fall 2023 Covid-19 vaccine. This amounts to ~3% of the eligible population (only 7% of nursing home residents). This is severely trailing typical flu vaccine coverage, just like last fall.

For those interested in nuance: Is this year trailing last year’s Covid-19 coverage too? Well, yes, as seen in the line above. But, we are comparing apples to oranges. The end of the public health emergency meant that states were no longer required to report vaccine uptake to the CDC, but some are still reporting. So, the 2023 numbers are the bare minimum. Models considering differential reporting show Covid-19 coverage is about the same as last year.

This is nothing to brag about.

Five reasons

Covid-19 is more transmissible, more severe, has more long-term implications, and is more unpredictable than the flu. So, why is coverage so much lower than flu?

1. Covid-19 circulates year-round, while flu circulates seasonally. This means that ~15% of the population was infected with Covid-19 this summer and do not need the fall vaccine yet.

2. Debate on eligibility. There is a debate about whether those under 65 “need” a Covid-19 vaccine. Many physicians I highly regard (but disagree with) are on the fence about recommending it for everyone. We don’t have this with flu.

3. Lack of access. The choppy rollout this fall is well documented. Even with distribution smoothed out, there is a lack of access. For some local health clinics, the vaccine costs more than they can afford or willing to financially risk. This is causing grave inequities. The closest place for my youngest is 50 miles away.

4. Fatigue. We have been hammered to get Covid-19 vaccines for the past three years. People are just… tired… of hearing about it.

5. Lack of resources. There is now zero federal money for a Covid-19 vaccine campaign for education and outreach. Health departments are on their own, too. (The panic and neglect cycle is too real in public health.)

So what should we do?

All of us—friends, family, neighbors, schools, pharmacies, doctor offices, health departments, employers—need to be laser-focused on “passive positives.”

This approach works with organ donations. We should do it with vaccines. And it’s beyond time we leverage behavioral science to get vaccinations in arms as much as we do bench science to get vaccines in vials.

In a Scientific American piece last week, I partnered with two leading psychologists on the what, how, and why behind passive positives. Check it out HERE.

Bottom line

Increasing trust, access, and coverage of vaccines will take an all-hands-on-deck approach. We are exhausted, but it’s worth the push—fewer lives will be lost, fewer work and school days will be missed, and our quality of life will improve.

Love, YLE

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“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH Ph.D.—an epidemiologist, wife, and mom of two little girls. During the day, she is a senior scientific consultant to several organizations. At night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below: