Promoting Adult Vaccinations: Protecting Patients and Public Health

As the annual adult vaccine season begins, ensuring access to vaccines for influenza, COVID-19 boosters, shingles (zoster), and pneumococcal disease remains a significant public health challenge.1 This is especially concerning among individuals at increased risk for complications from getting these diseases, including older adults, immunocompromised individuals, and those with chronic health conditions.2 The ripple effects of decreasing adult vaccination rates extend beyond individual and household health, straining healthcare systems in our communities, across the US, and globally.

Roots of Vaccine Hesitancy

            Internet and social media driven misinformation and distrust in public healthcare systems stand out as driving forces against post-childhood vaccinations. A recent World Health Organization (WHO) report raised concerns about the growth of infodemics – the rapid spread of excessive, misleading, and false information during health crises3 – and mistrust in pharmaceutical companies and government agencies intensified during the COVID-19 crisis.4 From my own clinical experience in medical school training, it is noteworthy that some adults perceive diseases like the flu or shingles as benign or avoidable through lifestyle choices. This sense of low personal risk can result in apathy towards preventive care. Despite public education efforts, many individuals are unaware of being due or overdue for recommended vaccines. In addition, lack of insurance coverage, transportation, and time off from work are also barriers, especially in rural and underserved areas.5,6

Health Implications for At-Risk Groups

            Adults with chronic conditions like diabetes, heart disease, asthma, and kidney disease face heightened risks from vaccine-preventable illnesses. Influenza can worsen underlying conditions like asthma, leading to hospitalization or death.7 Pneumococcal infections (potentially prevented by the pneumococcal vaccine) can lead to serious complications such as pneumonia, blood infections, and meningitis.8 COVID-19 vaccine hesitancy has amplified infections and deaths among high-risk individuals, including older adults.9 Even for healthy adults, shingles is not only painful but can result in long-term complications, such as postherpetic neuralgia, that significantly impair quality of life. 10

Burden on Healthcare Systems

            When adults forgo vaccinations, healthcare systems absorb the consequences. During seasonal flu and COVID-19 outbreaks, hospitalizations and emergency room visits surge, burdening strained healthcare staffing and resources.11 Post-childhood vaccine hesitancy contributes to higher healthcare costs, both directly through treatment and hospitalization, as well as indirectly, through loss of productivity and long-term disability. A 2022 report from the U.S. Centers for Disease Control and Prevention estimates that adult vaccine-preventable diseases cost the U.S. nearly $27 billion annually in direct medical expenses and lost productivity.2 Delays in care for non-infectious conditions may follow, since hospital beds and personnel are redirected to manage infectious disease outbreaks.

Strategies to Address Post-Childhood Vaccine Hesitancy

            To reverse this trend, a multi-pronged approach is needed. Enhancing public education campaigns is an evidence-based approach known to counter misinformation and boost trust in public health systems.12 By investing in transparent, accessible messaging tailored to diverse populations, and engaging with trusted local community leaders and healthcare professionals, Federal, state, and local health authorities could rebuild trust and make strides in correcting correct misinformation.12 Leveraging technology and data can also help. Digital health records and reminders can alert individuals, especially older adults, when vaccines are due. Text message campaigns and smartphone apps have shown promise in increasing vaccine uptake.13 Integrating vaccinations into routine care is essential to curbing vaccine hesitancy: primary care visits, pharmacy consultations, and hospital discharges are all opportunities to review and update adult vaccination status. Pharmacists are underutilized allies in vaccine delivery who can help improve vaccine uptake rates.14 Expanding insurance coverage for adult vaccines, offering mobile or pop-up clinics, and ensuring paid sick leave are evidence-based approaches to reduce structural barriers that prevent vaccination.15 A cultural shift is needed to view vaccination as a lifelong shield against disease, and the normalization of vaccines across the lifespan is a worthwhile goal. Celebrating days like vaccine anniversaries or annual wellness campaigns may help to embed vaccination into adult health routines. 

The Stakes are High

            Hesitancy toward adult vaccinations is more than an individual health decision; it is a societal challenge with far-reaching implications. Protecting populations at increased risk and preserving precious healthcare resources requires prioritizing vaccine education, accessibility, and integration into routine adult care. As science develops new vaccines and improve existing ones, we must ensure these life-saving tools reach the people who need them most. 

Learn more from these high-quality sources of information: 

  1. CDC: Vaccine Information for Adults
  2. Amir Qaseem, Christine Laine. The U.S. Founding Fathers Recognized the Benefits of Immunization—We Need That Same Recognition Today. Ann Intern Med.2025;178:886-892. [Epub 15 April 2025]. doi:10.7326/ANNALS-25-01576
  3. U.S. Department of Health and Human Services: Vaccines for Adults
  4. Mayo Clinic: Adult Health 

 

About Nicole Obongo

I am a fourth-year medical student at the Larner College of Medicine, pursuing a career in family medicine with interests in behavioral health, health equity, and public health advocacy. I wrote these blog posts to raise awareness about ongoing gaps in adult vaccination and the impact of food deserts on community health. These are critical, often overlooked issues that directly affect the well-being of the patients and communities I hope to serve.

References

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