Dr Len Friedland, vice president, director scientific affairs and public health at GSK, said that while the world rightly focuses on COVID-19 vaccinations, is it still critical that healthcare professionals also stress the need for other routine vaccination in their communities.
Citing a new Avalere study, he said that over 80% of surveyed payers in the US noted decreases in immunizations, as well as screenings for cancer, hypertension, and diabetes since the pandemic took hold.
The US Center for Disease Control and Prevention (CDC) also reported a decline in vaccine administration rates in Medicare beneficiaries aged over 65 years of age during the first half of 2020.
“COVID-19 has brought adult vaccination to the fore. We saw with COVID-19 that it was our older, adult population that was at particular risk for this disease. As we age our immune systems decline, and the weakening of the immune system places the elderly at risk for certain infection diseases,” said Friedland.
In the US, there are a number of vaccines that are routinely recommended for adults including the shingles vaccines for all adults over 50, the pneumococcal pneumonia vaccine for all adults over the age of 65, while the combined pertussis vaccine is another shot recommended for all US adults along with, of course, the influenza vaccine, and the hepatitis A and B vaccines are also advised as routine shots for adults.
“Those related diseases cause loss of work, hospitalizations and deaths as people age. In addition to advancing age, underlying chronic conditions such as diabetes and cancers or medication to treat certain diseases can suppress the immune systems in older adults, leaving them exposed to infectious diseases,” he said.
Shingles, while it does not result in hospitalizations in general, really impacts quality of life, it can cause a debilitating pain, he added. A case of pertussis can last three months. “Vaccination is a way to have healthy ageing.”
Have there been tangible impacts to date of the lower take-up of adult vaccines in the US?
“As people have been wearing masks, and implementing social distancing measures, we have seen that the rates of respiratory diseases such as the flu, and pneumococcal pneumonia have declined dramatically, globally. We did not have anything close to an influenza season this year, but there is a concern about what next year will bring, because people may not have had a prime to their immune system by being exposed to influenza or pneumococcal pneumonia this year. It is possible those diseases could be back in a big way next year. Now is the time we need to make sure people get their pneumococcal vaccines, and in the fall, the flu vaccines,” Friedland told us.
Lack of awareness
A survey conducted in August last year, The Harris Poll, commissioned on behalf of GSK, found that many adults ages 50-79 are unfamiliar with the vaccines recommended for them.
The online survey of more than 3,000 US adults ages 50-79 and more than 300 US primary care physicians indicates that adults are unlikely to receive many of the vaccines recommended for them:
- Approximately 1 in 4 older adults have never heard of or are unfamiliar with the adult vaccines for shingles (27%), tetanus, diphtheria, and pertussis (Tdap) (28%), and pneumonia (30%).
- Many older adults say they are not likely to receive the influenza (i.e., flu) (28%), shingles (38%), Tdap (44%), or pneumococcal (i.e., pneumonia) (54%) vaccines.
- More than half of older adults have never heard of or are unfamiliar with the vaccines for hepatitis B (55%) and hepatitis A (56%).
Prior to the emergence of the COVID-19 pandemic, vaccination coverage had begun to stagnate globally; the pandemic response and related disruption to healthcare delivery has potentially exacerbated this issue, said the GSK representative.
While missed doctor visits can explain the decline in immunization rates during the COVID-19 pandemic, Friedland acknowledges that there is also a lack of awareness, overall, among many adults about the existence of vaccines to protect them against infectious diseases. “Also a lot of adults think vaccines are just for children or teenagers.”
Vaccine hesitancy or a lack of vaccine confidence is another factor in stagnating immunization rates in older adults, said Friedland.
GSK is doing a lot work, he said, to raise awareness among adults about how key vaccination is as people age.
If a grandparent gets whooping cough or pertussis, they could potentially pass that on to their newborn grandchild, he said. “When that knowledge is out there, that adults realize it is important to protect themselves but also the people around them, it helps with immunization rates. This is potentially the silver lining in the COVID-19 pandemic, that it has created greater awareness around the benefits of vaccines for all ages, that more adults may now have a greater appreciation for the value of prevention through immunization."
The most important driver of adult vaccination is the doctor, and the retail pharmacist, he stressed: “One of the reasons those healthcare providers are not talking about adult vaccination as much as we would like is that they have other priorities – there are so many things to do during a typical 10 or 15 minute office visit.”
Friedland also noted lower vaccination rates in adults in the various ethnic communities in the US.
“While we have been focusing on US data here, we know that the declining trend in adult vaccination is a worldwide phenomenon,” he added.
As vaccination rates start to increase, Friedland said GSK can supply the doses necessary to meet that demand. “All vaccines have a shelf life – say two to three years. So if we see declining rates, [or the contrary] we can manage our inventory accordingly. Our team can speed up and slow down supply based on demand.”