The Confusing Landscape of Covid Vaccination: A Growing Concern
In a worrying trend, conflicting advice surrounding covid vaccines is predicted to further dent already low vaccination rates, according to healthcare experts. With over three-quarters of American adults opting out of covid shots last season, the situation may worsen due to recent U.S. government recommendations.
Initially, the covid vaccine gained widespread acceptance, with approximately 75% of Americans receiving at least one dose by early 2022. However, during the 2024-25 virus season, only around 23% of American adults chose to get vaccinated against covid, a stark contrast to the 47% who opted for the flu shot. This decline in vaccination rates extends to other diseases like flu, measles, and tetanus.
Despite these numbers, covid remains a significant health threat, claiming the lives of approximately 31,400 individuals last year, according to CDC data. In comparison, flu resulted in around 6,500 deaths, while pneumonia, a common flu complication, caused an additional 41,600 deaths.
As Americans decide on their covid vaccination status for the current season, public health researchers express concerns about further declines in vaccination rates. This worry is particularly acute for Hispanic and Black Americans, as well as those under 30, who have lower vaccination rates and are thus more vulnerable to severe complications like long covid. The Trump administration, under Health and Human Services Secretary Robert F. Kennedy Jr., has narrowed its covid vaccine recommendations, leading to a patchwork of rules on pharmacy access, with residents of Republican states often facing more barriers to vaccination.
"Misinformation about covid is rampant," warns Alein Haro-Ramos, an assistant professor at the University of California-Irvine. "Vaccine hesitancy is on the rise."
In August, the FDA narrowed covid vaccine approval to individuals aged 65 and older, and to adults and children with at least one underlying condition that puts them at high risk for serious covid complications.
A month later, the CDC's Advisory Committee on Immunization Practices voted to recommend "shared clinical decision-making" regarding the vaccine, moving away from advising all adults to get vaccinated. The committee advised doctors to emphasize to adults under 65 and children that the benefits of the vaccine are greatest for those with underlying health conditions.
This guidance has been challenged by infectious disease experts, who argue that most adults and children should receive both the flu and covid vaccines, which are safe, effective, and prevent serious illness. Several independent medical organizations, including the American Academy of Family Physicians and the American Academy of Pediatrics, have reaffirmed their support for widespread covid vaccine adoption.
More than two dozen states have taken steps to ensure most people can access covid vaccines at pharmacies without a prescription, with many states aligning their policies with the advice of medical organizations. Many of these states also require insurers to cover vaccines at no cost, according to a KFF analysis. In several other states, predominantly Republican-led, pharmacy access to vaccines may require a prescription.
Common reasons for covid vaccine hesitation include fears about side effects, long-term health consequences, and vaccine effectiveness, as well as mistrust of pharmaceutical corporations and government officials, according to a 2024 review published in the journal Vaccines.
Covid vaccine hesitancy during the 2024-25 virus season was higher among Latinos, African Americans, men, uninsured people, and residents of Republican-leaning states, according to CDC data. Latino adults were significantly less likely than adults from most other racial and ethnic groups to get vaccinated, with a vaccination rate around 15%.
Some of this hesitancy may be attributed to age, as a disproportionate number of Latinos are young. However, public policy actions may also play a role. For instance, the first Trump administration tied Medicaid to "public charge," a rule allowing the federal government to deny immigrants a green card or visa based on their dependence on taxpayer-funded programs. Some Latinos may be hesitant to enroll in social services, even after the Biden administration reversed these Trump-era actions.
Haro-Ramos, who co-authored a 2024 study, found that many Latinos were hesitant to vaccinate due to fears about their immigration status. The study also revealed that experiencing health discrimination, such as care denials or delays, increased vaccine hesitancy.
"Trust is paramount," Haro-Ramos said. "Do you trust the healthcare system? Do you feel comfortable providing your personal information?"
Haro-Ramos believes the problem has likely worsened since her study's publication. This summer, the Trump administration revealed plans to share personal information of Medicaid enrollees with Immigration and Customs Enforcement, leading many Latinos to cancel doctor appointments to avoid potential encounters with immigration enforcement officials.
"People are avoiding leaving their homes at all costs," Haro-Ramos added.
Janani Rajbhandari-Thapa, an associate professor at the University of Georgia College of Public Health, co-authored a recent study on covid vaccination among nearly 1,500 African Americans in south Georgia. The study found that participants were more likely to heed the advice of healthcare providers over faith leaders or coworkers when considering vaccination. While over 90% of those studied received at least one vaccine dose, the unvaccinated were more likely to believe false statements tying vaccines to miscarriages, long-term component retention in the body, or even the conspiracy theory of implanting computer chips.
"Clinicians are key to dispelling these myths," Rajbhandari-Thapa said.
Even though covid hospitalization and death rates have decreased since the pandemic's peak, fatal covid complications remain most common among older individuals. Approximately 89% of U.S. covid deaths last year occurred among people aged 65 and older, compared to about 81% of flu and pneumonia deaths.
As the pandemic recedes into the background, young people have developed a sense of invincibility. Only 11% of Americans aged 18 to 29 received a vaccine during the 2024-25 virus season, the lowest vaccination rate among adult age groups. This is a significant drop from the 70% of young adults who received at least one dose of the initial covid vaccines by November 2023.
Some misunderstand the purpose of the covid shot, believing it failed because they still contracted covid after vaccination, said Otto Yang, an infectious disease specialist at UCLA Health. "They think, 'The vaccine didn't prevent me from getting covid, so it didn't work.' What they miss is that the vaccine prevented them from becoming severely ill, which is the ultimate goal," Yang explained.
The vaccine can also help prevent long covid, a problem affecting all ages, Yang added. A recent Northwestern University study found that younger adults experience worse long covid symptoms than older adults.
Ultimately, Yang emphasized the importance of consistency: "If you get a flu vaccine, you should also get a covid vaccine, as both are safe, effective, and prevent serious illness. For those with compromised immune systems and higher risk, a covid shot is clearly recommended. For others, it's probably a good idea, just like the flu vaccine, and most children should also be vaccinated."
The decision to vaccinate against covid is a personal one, but with the potential for severe illness and long-term complications, it's a choice that warrants careful consideration.
