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Are Patients Receptive to an Annual COVID-19 Booster Shot, Vaccine?

Receptiveness to an annual COVID-19 booster shot comes as the US gets serious about transitioning to an endemic COVID-19.

Sara Heath
By
Published: 06 Apr 2023

Half of adults say they’d get an annual COVID-19 booster shot, not unlike getting their annual flu shot, according to the latest data from the Kaiser Family Foundation (KFF).

But still, less than a quarter (23 percent) of adults have gotten the most recent round of COVID boosters.

This data comes as the US gets serious about transitioning to an endemic COVID-19, with the federal public health emergency (PHE) slated to end in May of 2023. Considering the timing of getting COVID-19 booster shots is a key way to plan for COVID’s endemic future.

Although the bivalent booster shot, which was rolled out in the fall of 2022, didn’t see big uptake, the survey data indicated a yearly shot could be a viable approach. Around half (53 percent) of surveyed adults said they’d be at least somewhat likely to get an annual COVID-19 shot, with 32 percent of those adults saying they are very likely to get an annual shot.

That number is not dissimilar to the flu shot, which got around 50 percent coverage in the 2020-2021 flu season, per CDC figures.

People interested in a yearly COVID-19 shot are more likely to be at least vaccinated, with those who are both vaccinated and boosted being among the most likely to be interested in an annual shot. Overwhelmingly, people who also regularly get their annual flu shot are also likely to get an annual COVID-19 shot. That’s an important finding, considering the work being done to combine both an mRNA flu and COVID booster.

Although the KFF researchers did not explore why there is a disparity between people who have gotten the existing bivalent COVID-19 booster and those interested in an annual booster, convenience could be a part of it. Until now, the US has had a fragmented approach to boosters, which has left some unaware of when they should or should not get a COVID-19 booster.

Providing an annual COVID-19 shot might simplify this process by offering a schedule that is easy for patients to follow.

Patients unaware of potential PHE unwinding impacts

The survey also looked at whether people are concerned about the ending of the PHE. The PHE created numerous flexibilities, ranging from broader Medicaid eligibility to telehealth licensure flexibility. When the PHE ends, some of those flexibilities may go away, and that will have an impact on patients.

But the KFF survey showed that patients are largely unaware of that fact. One in five adults said they hadn’t heard anything about the Biden administration’s plan to end the PHE, and six in 10 said they don’t think the PHE’s ending will have any impact on them or their families. Another half said they don’t believe the PHE’s end will have an impact on the country overall.

Concerns about the PHE’s end are split along racial and income lines, the survey showed. Around three in 10 Black and Hispanic adults said they are worried about possible negative impacts from the PHE’s end. Meanwhile, 31 percent of those with lower annual incomes under $40K also expressed worry.

The reality is that the end of the PHE could have some impact on patients, especially those enrolled in public insurance programs. A December 2022 issue brief from the Urban Institute and the Robert Wood Johnson Foundation said the PHE’s end could spell loss of Medicaid coverage for 18 million beneficiaries. That would leave 3.8 million people potentially uninsured. Another 9.5 million people would likely enroll in employer-sponsored coverage.

And none of that accounts for other flexibilities that may go away, like telehealth regulations that let patients access certain types of care virtually. Notably, experts are eyeing flexibilities that let providers prescribe substance use disorder drugs via telehealth without an initial in-person encounter.

For its part, the Center for Medicare and Medicaid Services (CMS) has set up a special enrollment period on the Affordable Care Act (ACA) marketplaces for individuals who would lose Medicaid coverage when the PHE lapses. The agency said this is an effort to prevent lapses in insurance coverage and help streamline the process for beneficiaries.

But if the KFF numbers are any indication, not enough people know about these systems for them to have a significant benefit. It will be important for the government and other healthcare entities to ensure patients are aware of the changes coming down the pike as the PHE ends to ensure continuity in patient care access.

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