Document text
COVID -19 Vaccine Implementation
Shannon Stokley, DrPH
Deputy Director for Science Implementation
Immunization Services Division
National Center for Immunizations and Respiratory Diseases (NCIRD)
June 2024National Center for Immunization and Respiratory Diseases
2023 -2024 COVID -19 Vaccination Coverage
Percentage of Children Ages 6 Months –17 Years Who Are Up to Date with
the 2023-2024 COVID-19 Vaccine, NIS-CCM and NIS-FLU
As of May 11,
2024,
vaccination
coverage
among children
was 14.4% .
Data source, National Immunization Survey —COVID Child Module (NIS -CCM) and National Immunization Survey —Flu (NIS -Flu):
https://www.cdc.gov/vaccines/imz -managers/coverage/covidvaxview/interactive/children -coverage -vaccination.html
COVID -19 Vaccination Status Among Children Ages 6 Months –17 Years by
Demographics, NIS -FLU, May 5 –May 11, 2024 (n=2,950)
By age group:
• Vaccination coverage increased with
increasing age.
By race and ethnicity:
•Vaccination coverage was highest among
white, non-Hispanic children (15.2%) and
lowest among Black, non-Hispanic
children (10.9%).
Data source: National Immunization Survey – Flu Module About the National Immunization Surveys | CDC
COVID -19 Vaccination Status Among Children Ages 6 Months –17 Years by
Demographics, NIS-FLU, May 5 –May 11, 2024 (n=2,950)
By urbanicity:
• Vaccination coverage was lowest in rural
areas (8.4%).
By household income:
•Vaccination coverage was highest among
households with an income greater than
$75k (18.0%) and lowest among
households with an income lower than
$75k (9.4-11.3%).
Data source: National Immunization Survey – Flu Module About the National Immunization Surveys | CDC
Percentage of Adults ≥18 Years Who Are Up to Date with the
2023 -2024 COVID-19 Vaccine, NIS-ACM
Data source: https://www.cdc.gov/vaccines/imz -managers/coverage/covidvaxview/interactive/adult -coverage -vaccination.html As of May 11,
2024,
vaccination
coverage
among adults
was 22.5% .
COVID- 19 Vaccination Status Among Adults Age ≥18 Years by
Demographics, NIS-ACM, April 28-May 25, 2024 (n=47,953)
Vaccinated with 2023-24 COVID-19 vaccine18.016.017.715.321.323.520.317.521.023.211.814.518.923.535.436.019.722.8
0.0 20.0 40.0 60.0 80.0 100.0AI/ANMulti/OtherNH/OPIHispanicBlackWhiteAsianRuralSuburbanUrban18-2930-3940-4950-6465-7475+MaleFemale
Weighted % (95% CI)28.921.324.821.118.216.519.625.910.722.6
0.0 20.0 40.0 60.0 80.0 100.0Transgender/NonbinaryCisgenderGay/Lesbian/Bisexual/OtherStraightIncome unknownBelow povertyAbove poverty, <$75KAbove poverty, ≥$75KNot insuredInsured
Weighted % (95% CI)
AI/AN: American Indian or Alaska Native; NH/OPI: Native Hawaiian or Other Pacific Islander
Data source: National Immunization Survey – Adult COVID Module About the National Immunization Surveys | CDC
COVID -19 vaccination coverage among adults ≥18 years of age,
NIS-ACM, 2022-23* and 2023- 24
Updated 2023 -24 COVID -19 vaccination coverage as of May 25 , 2024, is 5.1 percentage points below the 2022 -23
bivalent vaccine peak coverage of 27.5%.
*
Provider Recommendation for COVID -19
Vaccine
39.9%
21.3%
2021 August
(7 mo. after vaccine
available)2024 May
(8 mo. after updated
vaccine available)Healthcare provider COVID -19 vaccine
recommendations, NIS -ACM
Relative to 2021,
adults reported
fewer providers
are recommending
COVID -19
vaccines .Percent of adults whose healthcare
provider recommends COVID-19 vaccine
Data source: National Immunization Survey – Adult COVID Module About the National Immunization Surveys | CDC
Percent of Adults ≥18 Years of Age Who Reported Receiving Any Kind of
COVID-19 Vaccine Recommendation Since September 14, 2023, by Age Group,
Provider Recommendation Survey, April 12-25, 2024 (N=3,004)
66.873.4
020406080100
Received any recommendationWeighted % (95% confidence interval)Age 18 -64 Age 65+
18.240.7
15.522.1
020406080100
Received recommendation through
conversation with provider/office
(N=2,984)Received recommendation through
conversation with pharmacist/pharmacy
(N=3,010)Weighted % (95% confidence interval)Age 18 -64 Age 65+Percent of Adults ≥18 Years of Age Who Reported Receiving Active* COVID -
19 Vaccine Recommendation Since September 14, 2023,† by Age Group,
Provider Recommendation Survey, April 12-25, 2024
*"Active recommendation" was defined as a provider, nurse/MA, pharmacist, or pharmacy technician/assistant mentioning the COVID -19 vaccine in person or during a telehealth visit, or a
personal phone call from a provider or pharmacist/pharmacy. “Passive recommendation" was defined as provider office reception staff mentioning the vaccine, seeing a sign at a provider
office or pharmacy, or receiving written information in person, an email, text message, automated phone call or voice message , or portal/app message from a provider office or pharmacy.
†The denominator for these estimates includes all respondents who answered the questions and was not limited to those who repo rted visiting a provider during the respiratory virus
season.
Percent of Adults ≥18 Years of Age Who Reported Receiving COVID -19 Vaccine Offer,
Referral , or Recommendation at In -Person Visit Since September 14, 2023 ,* by Age
Group, Provider Recommendation Survey, April 12 -25, 2024
*The denominator for these estimates was restricted to those who reported they had an in person visit to a provider since September 14, 2023.23.231.4
12.924.145.158.3
020406080100
Received offer (in office)
(N=1,984)Received referral (in office)
(N=1,980)Received recommendation (in office)
(N=1,987)Weighted % (95% confidence interval)Age 18 -64 Age 65+
41.641.546.4
41.440.439.2
33.3 31.030.7
14.717.3 16.4
13.319.3 19.127.232.0
22.2
020406080100
Protects me and loved ones Addressed concerns Negative effects of getting COVID -19
Especially important for you Personal/anecdotal experience None of the aboveWeighted % (95% confidence interval)Provider (N=531) Nurse/MA (N=265) Pharmacist (N=258)Topics Mentioned When Discussing Updated COVID -19 Vaccine with
Provider, Nurse/MA , or Pharmacist, Reported by Adults ≥18 Years of Age,
Provider Recommendation Survey, April 12 -25, 2024
Data source: “Provider Recommendation Survey”. 3,041 U.S. adults ages 18 years and older surveyed April 12 -25, 2024, via NORC’s probability -based AmeriSpeak Panel . Data were weighted
to represent the non -institutionalized U.S. population and mitigate possible non -response bias. All responses are self -reported.
Association of Provider Offer, Active* vs Passive Recommendation for COVID -19
Vaccine Since September 14, 2023, with Vaccination Among Adults ≥18 Years of Age,
by Age Group, Provider Recommendation Survey, April 12 -25, 2024
*"Active recommendation" was defined as a provider, nurse/MA, pharmacist, or pharmacy technician/assistant mentioning the COV ID-19 vaccine in person or during a telehealth visit, or a personal phone call from
a provider or pharmacist/pharmacy. “Passive recommendation" was defined as provider office reception staff mentioning the vaccine, seeing a sign at a provider o ffice or pharmacy, or receiving written information
in person, an email, text message, automated phone call or voice message, or portal/app message from a provider office or pha rmacy.
Data source: “Provider Recommendation Survey”. 3,041 U.S. adults ages 18 years and older surveyed April 12 -25, 2024, via NORC’s probability -based AmeriSpeak Panel . Data were weighted to represent the non -
institutionalized U.S. population and mitigate possible non -response bias. All responses are self -reported.46.2%
29.1%
20.5%
11.3%
0 20 40 60 80No offer or
recommendation
(N=738)Not offered, received
ONLY passive rec
(N=750)Not offered, received
active rec
(N=413)Offered vaccine
by provider
(N=368)
Weighted % (95% confidence interval)Age 18 -64 (N=2,269)
51.8%
62.5%
46.9%
19.7%
0 20 40 60 80No offer or
recommendation
(N=177)Not offered, received
ONLY passive rec
(N=152)Not offered, received
active rec
(N=206)Offered vaccine
by provider
(N=171)
Weighted % (95% confidence interval)Age 65+ (N=706)
Frequency of recommending COVID -19 vaccination to
eligible adult patients
Most providers reported recommending the COVID -19 vaccine to adults most
of the time or always.
11.8%14.6%
7.4%40.0%
26.3%
0%20%40%60%80%100%% of respondents selecting
response option (n=433)
Never Sometimes Half the time Most of the time Always11.7%14.0%
8.2%40.6%
25.4%
0%20%40%60%80%100%% of respondents selecting
response option (n=342)
Never Sometimes Half the time Most of the time AlwaysAdults ages 18 –64 years Adults ages 65 years and older
Data source: HaPPI Survey Collaborative, University of Iowa; RAND Corporation; CDC
Reasons reported for NOT recommending COVID -19
vaccine to eligible adult patients (18 –64 years )
Data source: HaPPI Survey Collaborative, University of Iowa; RAND Corporation; CDC48.0%
36.6%
35.4%
22.3%
22.0%
16.3%
14.9%
14.6%
13.9%
10.9%
10.6%
9.7%
8.9%
8.7%
5.9%
5.9%
4.5%
1.2%0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
The patient will refuse vaccination
They have a medical reason for not getting vaccinated
Patients are tired of hearing about COVID-19 vaccines
Patients are tired of hearing about vaccines in general
Other recommended vaccines for this age group are a bigger priority for me
Relatively high COVID-19 vaccine hesitancy for this age group in my community
The patient has concerns about their out-of-pocket vaccination cost
There isn’t enough time during a visit to discuss COVID -19 vaccines
Patients in this age group are unlikely to experience severe COVID-19 symptoms
Recommending COVID-19 vaccination could increase general vaccine hesitancy
There isn’t enough time during a visit to vaccinate
Other
Vaccination provides insufficient additional COVID-19 protection for this age group
If the patient is pregnant or trying to become pregnant
Vaccination doesn’t reduce COVID -19 severity for this age group
Vaccination is unnecessary for this age group if prior COVID-19 Hx
Patients in this age group are unlikely to get COVID-19
The COVID vaccine is unsafe for patients in this age group% of respondents selecting response option (n=404)
Frequency of recommending on -site COVID -19
vaccination to eligible pediatric patients
Approximately the same proportion of providers reported recommending the
vaccine sometimes, most of the time, and always.
16.7%25.5%
4.9%23.8% 24.7%
4.4%11.2%27.4%
7.1%26.0% 24.4%
3.6%10.4%25.8%
6.9%27.7% 28.2%
0.6%
0%20%40%60%80%100%
Never Sometimes Half the time Most of the time Always Don't see age
group% of respondents selecting
response option (n=365)
6 months-4 years 5-11 years 12-17 years
Data source: HaPPI Survey Collaborative, University of Iowa; RAND Corporation; CDC
Reasons reported for NOT recommending COVID -19
vaccine to eligible pediatric patients
Data source: HaPPI Survey Collaborative, University of Iowa; RAND Corporation; CDC39.1%
37.4%
36.8%
36.5%
32.8%
22.3%
22.3%
21.2%
17.1%
15.1%
9.9%
9.6%
9.3%
7.0%
6.7%
5.8%
5.5%
2.9%0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Relatively high COVID-19 vaccine hesitancy for this age group in my community
The parent will refuse to have their child vaccinated
Other recommended vaccines for this age group are a bigger priority for me
The parent will be hesitant about having their child vaccinated
Parents are tired of hearing about COVID-19 vaccines
They have a medical reason for not getting vaccinated
Patients in this age group are unlikely to experience severe COVID-19 symptoms
Parents are tired of hearing about vaccines in general
COVID-19 vaccine recommendation could increase general vaccine hesitancy
There isn’t enough time during a visit to discuss COVID -19 vaccine concerns
The parent has concerns about their out-of-pocket vaccination cost
Vaccination provides insufficient additional COVID-19 protection for this age group
Other
Vaccination doesn’t reduce COVID -19 severity for this age group
There isn’t enough time during a visit to administer the vaccine
Vaccination is unnecessary for this age group if prior COVID-19 Hx
Patients in this age group are unlikely to get COVID-19
The COVID vaccine is unsafe for patients in this age group% of respondents selecting response option (n=345)
2024 -2025 COVID -19 Vaccine
Implementation
Prospective 2024 COVID -19 vaccine timeline
Apr May Aug Jul Jun Jan Dec Nov Oct Sept
WHO
Technical Advisory
Group on COVID- 19
Vaccine Composition
Recommendation:
Monovalent JN.1
lineage (4/15- 16)ACIP votes on
proposed
recommendations
(6/26–28)*FDA
Advises: Monovalent JN.1
lineage; KP .2, if feasible Vaccine available to ship
(Potentially mid -Aug to late -Sept
contingent on FDA
authorizations/approvals)
Providers administer vaccine
(Orders anticipated in offices 1-2 weeks
after FDA action)
*CDC publishes MMWR policy note following ACIP and FDA action (potentially late August to late September).
**CDC updates COVID -19 Vaccine Interim Clinical Considerations immediately following FDA action.
•Similar to the 2023 -2024 season, CDC plans to approach the 2024 -2025
fall/winter respiratory season comprehensively.
-CDC will develop and deliver clinical education materials, tools, and training to
increase provider knowledge.2024 -25 respiratory virus vaccine program
Goal: To help prevent disease, disability, and
death from COVID-19, influenza, RSV, and other
respiratory diseases.
•The Affordable Care Act (ACA) requires insurers to cover most ACIP -
recommended vaccines without cost sharing by the next coverage year.1
•Section 3203 of the Coronavirus Aid, Relief, and Economic Security
(CARES) Act expedites coverage of COVID -19 vaccines beyond that which
is required of most preventive services.2Insurance plans will cover the 2024 -2025 COVID -19 vaccines
immediately
1. 42 U.S. Code § 300gg –13 - Coverage of preventive health services. https://www.law.cornell.edu/uscode/text/42/300gg -13
2. FAQs about Affordable Care Act Implementation Part 50: https://www.dol.gov/sites/dolgov/files/EBSA/about -ebsa/our -activities/resource -center/faqs/aca -part -50.pdf
•COVID -19 vaccines are covered under Medicare without cost -sharing.
•Most Medicaid beneficiaries have access to COVID -19 vaccines without cost -sharing.
•Inflation Reduction Act, passed in August 2022, includes key provisions:
-Eliminates cost -sharing for all ACIP -recommended vaccines under Medicaid and Medicare Part D
equivalent plans
-Expanded coverage of all ACIP -recommended vaccines without cost -sharing to adult Medicaid
beneficiaries
-Guarantees that nearly 50 million Medicare beneficiaries and more than 80 million Medicaid
beneficiaries will have access to all vaccines recommended by ACIP without cost -sharingIndividuals with Medicare and Medicaid will also have
access to COVID -19 vaccines at no cost
https://www.dol.gov/agencies/ebsa/about -ebsa/our -activities/resource -center/faqs/aca -part -58
https://www.healthcare.gov/coronavirus/
•Eligibility: Children 0 through 18 years of age who meet at least one of the
criteria:
-Medicaid eligible
-Uninsured, or
-American Indian/Alaska Native, or
-Underinsured*Eligible children can receive COVID -19 Vaccines at no cost
through the Vaccines for Children (VFC) Program
*Eligible to receive vaccine only through an enrolled Federally Qualified Health Center (FQHC), Rural Health Center (RHC) or a deputized provider under Delegation of Authority
https://www.cdc.gov/vaccines/programs/vfc/providers/index.html
•CDC’s Bridge Access Program has provided free COVID -19 vaccines to
adults without health insurance and adults whose insurance does not
cover all COVID -19 vaccine costs during the 2023 -2024 season.
•Due to the Congressional funding recissions, the Bridge Access Program
will sunset in August 2024, and will not be available to cover the 2024 -
2025 COVID -19 vaccine.COVID -19 Bridge Access Program
•Once 2024 -2025 COVID -19 vaccines become widely available,
Vaccines.gov will operate as a search tool to help people find
pharmacies near them.
•Users must verify vaccine availability for themselves. Pharmacy contact
information will be provided in the search results for that purpose, as
well as for users to inquire about appointments.Vaccines.gov
For more information, contact CDC/ATSDR
1-800-CDC-INFO (232 -4636)
TTY: 1 -888-232-6348 www.cdc.gov www.atsdr.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry.
Thank you