Centers for Disease Control and Prevention (CDC)-recommended vaccinations for teens and adults continued to lag in 2020 and into the summer of 2021, according to a follow-up claims analysis commissioned by GSK and conducted by Avalere Health, an Inovalon company. This assessment follows two previous reports tracking the pandemic’s significant effect on routine vaccination.
Key findings include:
From January 2020-July 2021, monthly vaccine claims decreased on average 32% for adults and 36% for adolescents when compared to the same months in 2019.
Cumulatively, adults and teens may have missed an estimated 37.1 million doses of recommended vaccines compared to 2019.
“It's very concerning to continue to see millions of missed CDC-recommended vaccinations among both vulnerable age groups,” said Barbara Howe, MD, Vice President and Director, Vaccines Medical and Clinical, US at GSK. “We know the ongoing pandemic presents challenges to important efforts to catch up and then exceed pre-pandemic vaccination levels, but we must not become complacent. Lower vaccination rates cannot become the norm, or we may find ourselves grappling with a number of public health crises for diseases that could have been prevented.”
The latest analysis was conducted as follow-up to a series of analyses in February and June 2021 that found persistent and sometimes steep declines in vaccination claims for CDC-recommended teen and adult vaccines since the start of the pandemic. The analysis compared claims for CDC-recommended vaccines across commercial, managed Medicaid, Medicare Advantage and Medicare fee-for-service Part B for December 2020–July 2021 compared to the same months in 2019.
“In the US, the pandemic has elevated the value, impact and understanding of vaccines in helping to prevent disease and death, especially in the adult and older adult populations,” said Judy Stewart, GSK Senior Vice President and Head of US Vaccines. “We must not lose sight of the longstanding recommendations for routine vaccines across all age groups that are often underutilized, leading to significant medical, economic and societal costs that could otherwise be prevented by timely vaccination.”
The CDC recommends vaccines to protect teens against certain types of meningitis and HPV, and adults against pneumonia, shingles, hepatitis A, and hepatitis B, among others. Diphtheria, tetanus, pertussis (Tdap) vaccine and an annual influenza shot are recommended for both teens and adults. In May of 2021, the CDC issued guidance that COVID-19 vaccines and other vaccines can be administered to people on the same day.
The methodology employed is consistent with the previously reported analysis. Avalere analyzed changes in administration of ACIP-recommended adult (≥19 years of age) and adolescent (7-18 years of age) vaccines using pre-adjudicated medical benefit Medicare fee-for-service (FFS) claims and the Inovalon MORE2 Registry®, a large scale, real-world dataset consisting of medical, pharmacy, and lab claims and clinical data on more than 338 million de-identified patients.
Specifically, vaccines were identified using Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) for vaccine products, general vaccine administration HCPCS codes and National Drug Codes (NDCs) when product codes were not available. Avalere compared vaccine claims in 2020 and 2021 to vaccine claims in 2019 to identify the potential impact of the COVID-19 pandemic on vaccine administration.
Claims for nearly all vaccines covered in this analysis are observed in the Medicare Part B data. While Part D claims were not included in the analysis of FFS Medicare claims, some claims for Part D vaccines that were administered in the provider setting may have been captured. Due to variability across states in billing requirements for vaccines provided through the Vaccines for Children program, this analysis may not fully capture teen vaccine utilization in the Managed Medicaid market.
To estimate missed doses at a national level, Avalere used a market-specific, rate-based methodology to extrapolate the number of vaccine claims to the national population. The 2019 claims-based vaccination rate applied to the national sample was considered the baseline for vaccination volumes, and missed doses were estimated as a difference between the baseline and the 2020 and 2021 claims-based rate applied to the 2020 and 2021 national population estimates.
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