Americans are not getting seasonal vaccines ahead of the holidays

As the holiday season approaches, public health experts are sounding the alarm about low vaccination rates against the coronavirus, flu and RSV. With gatherings and travel on the rise, many people are heading into the next few months unprotected against these respiratory illnesses, which typically peak from December to February.

Experts worry that the unenthusiastic embrace of vaccines could spark outbreaks and increased hospitalizations.

As of this month, about 37 percent of adults 18 and older had received a seasonal flu shot, while 19 percent had received updated coronavirus vaccines and 40 percent of adults 75 and older — the group at greatest risk — got an RSV vaccine.

The vaccination rates are similar to last year’s figures, and the numbers reflect a persistent public health challenge achieving broader vaccine uptake for these illnesses.

In December 2023, the percentage of adults 18 and older who had received the flu vaccine was 42 percent. The vaccination rate for the coronavirus was 18 percent, and only 17 percent of adults 60 and older had been vaccinated against RSV; this year, that jumped to more than 31 percent.

Coverage was lowest in both years among people without insurance who said they are not likely to get the flu or coronavirus vaccines. People in cities and suburbs are more likely to get vaccinated than people in rural areas. Young people are less likely to be vaccinated than their elders.

About 9 percent of children younger than 18 have received this year’s coronavirus shot, while 33 percent have been vaccinated against the flu. To protect infants from RSV, vaccination is recommended during pregnancy, and monoclonal antibody treatment is advised for babies younger than eight months entering their first RSV season. As of March, 41 percent of eligible infants had received the RSV antibody treatment.

“There’s a large portion of the population that isn’t necessarily anti-vaccine, but maybe is hesitant to get their vaccine,” said Andrew Stanley Pekosz, a molecular microbiologist and immunologist at Johns Hopkins Bloomberg School of Public Health. “They just don’t know what to believe and when you don’t know what to believe, you end up not doing anything.”

Vaccine hesitancy, already a concern before 2020, worsened during the coronavirus vaccination campaigns and has affected other routine vaccines, experts say.

A 2024 survey by the Annenberg Public Policy Center of the University of Pennsylvania found that confidence in the coronavirus vaccine has dropped. The belief that it is safer to contract the virus than to vaccinate has increased from 10 to 22 percent since April 2021. And the percentage of people who believe that the coronavirus vaccine changes a person’s DNA increased to 15 percent compared with 8 percent in April 2021.

The release of coronavirus vaccines in 2020 led to numerous studies confirming their efficacy and safety. Despite research dispelling many false claims, public mistrust was fueled by mixed messaging and exaggerated claims, causing many people to feel misled, according to medical experts.

“There has been a loss of trust in science over the course of the pandemic,” said Tara Kirk Sell, a senior associate at the Johns Hopkins Center for Health Security. “There is something here when it comes to what people trust and how it sort of aligns with their preexisting values and beliefs.”

“People were asked to do things like close down their businesses for a while or to get a vaccine when they don’t feel like they really needed those things, and those things affected how people perceived public health,” Sell said.

The United States invested more than $7 billion in the We Can Do This public education campaign to vaccinate the public and to inform people about the coronavirus. As these efforts have declined, doctors and medical professionals shoulder responsibility for motivating patients to get vaccinated.

After the efforts during the coronavirus pandemic, attention shifted to the RSV vaccine, first approved in 2023 as a one-time dose. It is broadly recommended for adults 75 and older, but people at risk for severe disease between 60 and 74 are also encouraged to get the shot. So far, uptake has been low compared with the flu shot. Public health experts say the vaccines are effective, but more people need to get the shot of protection against respiratory syncytial virus.

Paul E. Sax, clinical director of the division of infectious diseases at Brigham and Women’s Hospital in Boston, said he urges the coronavirus vaccines for his older patients who are more susceptible to severe illness from a virus, but doesn’t push it as much for younger patients.