COVID-19’s Ongoing Impacts: Addressing Vaccine Fatigue and Improving Uptake

Announcer:
You’re listening to VacciNation on ReachMD, and this episode is sponsored by Pfizer. Here’s your host, Dr. Charles Turck.

Dr. Turck:
Welcome to VacciNation on ReachMD. I'm Dr. Charles Turck, and joining me to discuss the year-round impacts of COVID-19 is Dr. William Schaffner. He's a Professor of Preventive Medicine and Health Policy, as well as a Professor in the Division of Infectious Diseases at Vanderbilt University. Bill, thanks for being here today.

Dr. Schaffner:
Good to be with you, Charles.

Dr. Turck: 
So starting with some context, CDC data from 2024 shows that COVID-19 accounted for 40 percent more hospitalizations than flu and exceeded all other vaccine-preventable respiratory deaths combined. So what does that tell us about the ongoing importance of vaccinations?

Dr. Schaffner:
Charles, just as you say, COVID is still with us, but I'm afraid many of our patients have kind of put COVID behind them. They don't recognize that COVID, still, on an annual basis, causes substantial illness, hospitalization, and even deaths here in the United States. So we're going to have to educate them about that. This is particularly true for people who are at higher risk of getting severe disease. We're just going to have to reach out to them and do a lot of education. And it reinforces the importance of vaccination, of course, because vaccines clearly do prevent many of the more serious aspects of COVID. It is still a very valid preventive measure that we can extend to our patients.

Dr. Turck:
Now, from my understanding, there seems to be a persistent belief that COVID-19 is just a winter issue at this point, but surveillance data show that summer surges have become common. So how can we reframe this narrative?

Dr. Schaffner: 
You're absolutely right. Up to this point, we've largely associated COVID with flu. And of course, we vaccinate against influenza and therefore COVID every fall in order to prevent or mitigate the winter increase. But COVID is like a two-hump camel in that it also has that increase in the summer, which is really quite substantial. So we as providers have to educate ourselves and also our patients that they'll have to come in for a dose of vaccine before the summer increase and another before the winter increase.

We know that COVID vaccines provide a very good antibody response and protection, but it does begin to wane after a period of months. It doesn't go down to zero, but we do have to boost that antibody protection periodically. And for people in high-risk groups, that means twice a year, not just once.

Dr. Turck: 
And when it comes to our at-risk populations, which groups continue to face the gravest threats?

Dr. Schaffner: 
The people who are at greatest risk of severe disease, defined by hospitalization, intensive care unit admission, and the risk of dying, of course, are people, first of all, who are older. No great surprise. If you are older than 65 years of age, that population accounts for about 80 percent of the hospitalizations and deaths. And with each decade older than 60 or 65, you pick up even more risk. Now, for people who are younger than age 65, it's those with underlying illnesses: any kind of chronic disease, heart disease, lung disease, diabetes, which is so common, being obese, kidney disease, lung disease—also if you're immune compromised, and of course, pregnant patients.

Dr. Turck: 
For those just joining us, this is VacciNation on ReachMD. I'm Dr. Charles Turck, and I'm speaking with Dr. William Schaffner to gain deeper insight into the ongoing burden of COVID-19.

So given what we know about this disease’s year-round behavior, Bill, how can we counsel patients about the importance of continued COVID-19 vaccinations?

Dr. Schaffner: 
I think we just have to bring it up whenever we see patients in any context, so that they get to understand that COVID has not disappeared, that it concerns us, and therefore should be taken into account by them, and then, as a consequence of that, what their behaviors have to be. And we're talking principally about vaccination, so we have to let them know when to come in for vaccine and why vaccine is so very important for them. So this is a big educational effort that we're going to have to make. The Latin root of the word doctor is docere: to teach. Doctors are teachers; we're going to have to keep teaching about this.

Dr. Turck: 
And if we zero in on vaccine fatigue for just a moment, what contributes to it and how can we address it?

Dr. Schaffner: 
Well, vaccine fatigue is part of a whole larger picture of vaccine hesitancy and skepticism, right? And of course, many inoculations are not things that anyone looks forward to. So we're going to have to keep reassuring patients in that regard. It's also true—and I wish it were not—that there are some patients who just don't want anything to do with mRNA vaccines. And so we have the opportunity to let them know that there's now a more traditional, protein-based vaccine that's available to them, so they can take advantage of that.

Dr. Turck:
So to close out our discussion today, Bill, what practical strategies would you recommend to help integrate COVID-19 vaccination into the flow of routine care?

Dr. Schaffner: 
Well, routine is the answer. Just as we routinely have influenza vaccine available in our practices, Charles, we need to have COVID vaccine routinely available. And I think we as providers and everyone else who works with us should be in tune, singing the same song to all our patients: “Oh, we'll see you again in a few months, and you'll get your spring/summer COVID vaccine. We look forward to seeing you,” so that everybody reinforces this important notion. And the patient leaves saying, “Even though I'm not so sure about it, wow, they really think this is important.”

Dr. Turck: 
Great recommendations for us to think about as we come to the end of today's program. And I want to thank my guest, Dr. William Schaffner, for joining me to discuss the year-round challenges that COVID-19 continues to pose. Bill, it was great having you on the program.

Dr. Schaffner: 
My great pleasure, Charles.     

Announcer:
This episode of VacciNation was sponsored by Pfizer. To access this and other episodes in our series, visit VacciNation on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!