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Access, not hesitancy, stymies flu vaccine rates
Surveying shows vaccine hesitancy isn't all that's dampening flu vaccine rates, as care access and mixed messaging keep people who want the shot from receiving it.
The nation's middling flu shot rates might not be about vaccine hesitancy after all, according to a new survey conducted by the National Foundation for Infectious Diseases. Instead, patients are hitting care access barriers, keeping them from getting their vaccines ahead of respiratory virus season.
The survey of 1,200 adults found near-universal approval of vaccines, with 89% agreeing that anyone who wants a vaccine should be able to get one. Another 77% agreed that vaccines are the best, most proven way to protect against serious infectious diseases, while 71% said the benefits of vaccines outweigh any risks associated with them.
These findings come ahead of respiratory virus season -- think the flu, COVID-19, pneumonia and RSV. Major industry organizations, from the American Academy of Family Physicians to the American Academy of Pediatrics, have endorsed these vaccines for eligible people.
But those organizations have faced an uphill messaging battle, combatting new and conflicting advice from the nation's public health agencies, including the Centers for Disease Control & Prevention .
But this latest report turns that notion on its head, suggesting that people aren't reticent to get their flu shots. Instead, the nation's subpar flu vaccination rate -- only 43% of people of any age got a flu shot in the 2024-2025 flu season -- could be due to poor patient access to care.
According to the data, about a fifth (22%) of respondents said they tried to get at least one respiratory illness vaccine last year but faced issues such as a lack of appointment availability or long wait times. This was most common for the RSV vaccine (23%) and pneumococcal vaccine (27%).
These findings might warrant a second look at vaccine access and capacity.
The public overwhelmingly prefers to get their vaccines at a pharmacy, with 51% of respondents saying they went there for a flu shot, 60% for a COVID-19 shot, 47% for the RSV vaccine and 50% for the pneumococcal vaccine. The doctor's office or clinic was the second-most preferred location for getting a vaccine.
Population and public health experts need to assess that data to understand where patients are trying to get their vaccines, where they're falling short and where they need to expand capacity. For example, if there are not enough appointments to meet demand at the local pharmacy, public health leaders might consider strategies to help that pharmacy expand capacity.
Public health messaging must clarify vaccine recommendations
Those care access trends notwithstanding, it's important to acknowledge the public's misunderstandings around respiratory vaccines.
The survey showed that many are unsure which vaccines they're actually eligible for.
This trend was particularly pronounced when looking at the COVID vaccine. Around half of respondents (49%) said the COVID vaccine was not recommended for someone like them, while 29% were unsure whether it was recommended for their demographic.
More than a quarter (28%) said the flu shot is not recommended for someone like them, while 17% said they were unsure.
The public also tends to underestimate the severity of respiratory disease burden.
For example, less than half of the respondents correctly identified RSV as the leading cause of hospitalization among infants. Meanwhile, only 11% knew how serious the 2024-2025 flu season was, the most recent for which we have data. This group correctly identified the CDC estimate of 710,000 hospitalizations during that flu season, compared with half who thought the hospitalization rate was 400,000 that year.
The researchers advised combining vaccine messaging with information on disease implications and on who should receive which vaccines.
Furthermore, doctors, nurses and pharmacists -- all of whom are trusted by more than half of respondents -- need the right tools to help facilitate vaccine discussions with patients.
Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.
