Medicaid beneficiaries in the United States have historically had lower vaccination coverage than populations with other insurance types, in part because of access barriers. The COVID-19 pandemic disrupted routine healthcare delivery and contributed to changes in vaccine uptake. Pharmacies provide a widely available, nonmedical community setting that can increase convenience and access for vaccination. This analysis examined trends in pharmacy-based vaccination versus medical settings among Medicaid enrollees aged ≥9 between 1 January 2018 and 31 December 2023 to characterize shifts before and after the pandemic period.
The investigation was a retrospective claims analysis covering 1 January 2018 through 31 December 2023. The cohort included Medicaid recipients aged 9 years and older across the United States. The study quantified the percentage of all routine and seasonal vaccinations that were administered at pharmacies versus other medical settings and assessed the overall percentage change in vaccination rates across the study interval. Analyses were stratified by age and by race or ethnicity where data permitted. Detailed sampling frames, inclusion/exclusion criteria, statistical methods, and absolute denominators were not reported in the abstract and are not available in the source text provided here.
Two overarching patterns emerged. First, with some vaccine- and age-specific exceptions, overall routine and seasonal vaccination rates in Medicaid beneficiaries remained lower in 2023 than during the 2018–2019 pre-pandemic period. Second, the proportion of vaccinations delivered in pharmacies increased across the study period among adults.
Reported declines in overall vaccine administration included:
Despite these declines in absolute vaccine administration, pharmacy-based delivery rose. Among adults aged 19–49, the percentage of specific routine and seasonal vaccines administered at pharmacies increased by 5.2 to 17.5 percentage points for hepatitis A, hepatitis B, HPV, meningococcal, pneumococcal, and tetanus-containing vaccines.
The study reports age-specific patterns: adolescents experienced notable decreases in vaccination for HPV, influenza, and Tdap/Td when comparing 2023 to 2018–2019. Adults across a range of age groups showed lower vaccination rates in 2023 versus the pre-pandemic period for several vaccines commonly recommended for adults, including hepatitis A, influenza, meningococcal, pneumococcal, and tetanus-containing vaccines.
Concurrently, the shift toward pharmacy administration was most apparent in adult age groups. The largest documented pharmacy uptake among adults aged 19–49 covered multiple vaccine types and was quantified as increases of 5.2–17.5 percentage points in the share of vaccinations delivered in pharmacies for several vaccines.
When stratified by race or ethnicity, pharmacy-based vaccination was most frequently recorded among White enrollees, followed by Black enrollees, and then Hispanic enrollees. These differentials were observed across age groups and were less pronounced in adults aged 65 and older. The abstract does not report absolute rates, confidence intervals, or adjusted comparisons by socioeconomic or geographic factors, nor does it provide underlying counts for racial/ethnic strata.
In this Medicaid population, overall routine and seasonal vaccine administration remained lower in 2023 compared with the 2018–2019 pre-pandemic period for several vaccines and age groups. At the same time, pharmacies accounted for an increasing share of vaccine delivery among adults, with measurable increases for a range of vaccine types in adults aged 19–49. The authors highlight pharmacies as an expanding access point for vaccination in Medicaid beneficiaries and suggest that pharmacy-based services may play an important role in improving access to both routine and seasonal vaccines for underserved populations.
The abstract notes policy relevance: as public health strategies evolve post-pandemic, expanding access to pharmacy vaccination for Medicaid enrollees could help improve uptake and potentially reduce disparities. Specific recommendations, cost analyses, or state-level policy comparisons are not reported in the provided source summary.
The COVID-19 pandemic disrupted health services and vaccine delivery. This study analyzed Medicaid claims from 2018 through 2023 and found that, overall, many routine and seasonal vaccination rates had not returned to pre-pandemic levels by 2023. However, pharmacies delivered a larger proportion of vaccinations over time, particularly among adults. Pharmacy vaccination was most common among White enrollees, then Black and Hispanic enrollees, with smaller racial/ethnic differences in older adults. The findings support the role of pharmacies as accessible sites for vaccination that may help increase vaccine access in Medicaid populations; the abstract suggests expanding pharmacy access could aid recovery of vaccination coverage and reduce disparities. Details on sample sizes, analytic methods, and absolute vaccination rates were not reported in the abstract provided here.