More than three-quarters of US adults were not vaccinated against Covid last season, and health experts warn that number could rise this year due to new recommendations from the federal government.
The Covid vaccine was popular at first. In the first months of 2022, about 75% of Americans received at least one dose the first versions of the vaccine, according to the Centers for Disease Control and Prevention (CDC).
However, in the 2024-2025 season, only about 23% of adults were vaccinated against covid, significantly lower than the 47% who received a flu vaccine.
Vaccination rate flu, measles and tetanus also decreases.
However, Covid remains a serious and potentially deadly risk. It was the leading cause of death last year, recorded on about 31,400 death certificates. By comparison, the flu caused about 6500 deaths and pneumonia – a common complication of influenza – caused another 41,600, According to the CDC.
As millions of people decide whether or not to get vaccinated this season, public health researchers worry that vaccination rates will continue to fall, especially among Hispanics, African Americans and people under 30, who have lower immunization rates and are more at risk of complications such as long-term Covid.
Under the Trump administration and Health and Human Services Secretary Robert F. Kennedy Jr., the federal government has limited its guidance on Covid vaccines, creating a patchwork of rules for accessing vaccines at pharmacies. Republican-run states often have more barriers to getting doses.
“There’s a lot of misinformation floating around about Covid,” he said. Alin-RomaAssociate Professor of Health, Society and Behavior at the University of California, Irvine. “Vaccine hesitancy will grow.”
In August, the Food and Drug Administration (FDA) limited approval coronavirus vaccines for people aged 65 and older, and adults and children with at least one underlying medical condition that puts them at high risk of serious complications.
One month later, the CDC's Advisory Committee on Immunization Practices voted to recommend “shared clinical decision”which changes the general indications for vaccination of all adults. The committee advised doctors to explain to adults under 65 and children that the benefit of the vaccine is greatest for people with pre-existing health conditions.
The guidance has been rejected by infectious disease experts, who say most adults and children should get both flu and Covid vaccines because both vaccines are safe, effective and prevent serious illness.
Several independent medical organizations, such as the American Academy of Family Physicians and the American Academy of Pediatrics, have reiterated their support for widespread adoption of the Covid vaccine.
More than two dozen states have taken steps to ensure that most people can get Covid vaccinations at pharmacies without a prescription, and many are basing their policies on recommendations from scientific organizations.
In addition, many of these states require insurers to cover vaccines at no cost. CFF analysis. In other states run largely by Republicans, pharmacies may require a prescription to administer the vaccine.
According to a review of multiple studies published in the journal Covid-19, the most common reasons for refusing a Covid vaccine include fear of side effects, concerns about long-term consequences, doubts about its effectiveness and mistrust of pharmaceutical companies and authorities. 2024 in the magazine Vaccine.
CDC data shows that Covid vaccine hesitancy in the 2024-2025 season was highest among Hispanics, African Americans, men, people without health insurance and people living in Republican-leaning states.
Hispanic adults were significantly less willing to get vaccinated than most other racial and ethnic groups, with a vaccination rate of about 15%.
Part of this situation may be due to age: a large portion of the Hispanic population young. But public policy can also play a role. For example, the first Trump administration tied Medicaid to the “public charge” rule, a rule that allowed immigrants who relied on government-funded programs to have their residency or visa waived. Some Latinos may still be afraid to sign up for social services, even after the Biden administration ended the rule.
Haro-Ramos was co-author of the studypublished in 2024, which found that many Latinos were hesitant to get the vaccine due to concerns that it would affect their immigration status, and that discrimination in the health care system, such as denials or delays in care, contributed to that hesitancy.
“Do you trust the healthcare system as a whole? Would you like to provide your information: your name, your address?” – Haro-Ramos asked. “Trust is the key to success.”
According to Haro-Ramos, the problem has likely gotten worse since his study was published. this summerThe Trump administration said it would provide Immigration and Customs Enforcement (ICE) with personal information about people on Medicaid. Many Latinos canceling doctor visits to avoid possible meetings with immigration agents.
“People are avoiding leaving their homes at all costs,” he said.
Janani Rajbhandari-TapaAssociate Professor, College of Public Health, University of Georgia, was recently co-authored a study about vaccination against Covid among almost 1,500 African Americans living in southern Georgia. The study found that when seeking advice on whether to get vaccinated, participants tended to look more closely to their health care providers than to religious leaders or co-workers.
More than 90% of participants received at least one dose of the vaccine, but those who were not vaccinated were more likely to believe false claims, such as that the vaccine causes miscarriages, that it stays in the body for a long time or even that it contains a microchip.
“It is doctors who can explain that these ideas about the vaccine are myths,” Rajbhandari-Thapa said.
Although hospitalization and death rates from Covid have dropped significantly since the worst of the pandemic, fatal complications are still more common among older people. Last year, approximately 89% of Covid deaths in the US were among people aged 65 years and older, compared with 81% deaths from influenza and pneumonia.
With the pandemic behind us, many young people have developed a sense of invulnerability. Only 11% of Americans ages 18 to 29 were vaccinated during 2024-25, the lowest rate among adult age groups. This contrasts with 70% of young people who have received at least one dose of the primary Covid vaccine by November 2023.
While many people contract Covid even after vaccination because protection against infection wanes quickly, some misunderstand the purpose of the vaccine, he explained. Otto Young, infectious disease specialist at UCLA Health.
“They think, 'Well, I got Covid despite the vaccine, so it didn't work,'” Yang said. “And what they don’t see is that the vaccine prevented them from getting seriously ill, and that’s the most important thing.”
Yang added that the vaccine could also help prevent long Covid, a problem that can affect people of any age. A recent study from Northwestern University found that young people They suffer more severe symptoms of long Covid than older people.
Ultimately, Yang said, there is no point in getting the flu shot rather than the Covid vaccine because both are safe, effective and prevent serious illness. Obviously, he added, people with weakened immune systems and those at higher risk should get vaccinated against Covid. The decision is “a little less clear” for others, “but most adults should probably get the vaccine, just as the flu shot is recommended, and most children should as well.”
Philip Reese is a data journalist and assistant professor of journalism at California State University, Sacramento.
