OBJECTIVES: The COVID-19 pandemic highlighted the importance of national immunization strategies. During COVID-19, there was increased focus on the importance of vaccination and challenges of vaccine hesitancy. Vaccine hesitancy is complicated by vaccine fatigue, stemming from the multiple doses of COVID-19 vaccine required. What is less understood is the impact of this increased focus on vaccination, and its relation to vaccine hesitancy/fatigue on other immunizations. The objectives of this study were to assess trends of influenza, Tdap, Shingrix, and HPV vaccination rates before, during, and after the pandemic, and to identify relationships between vaccination fatigue/hesitancy for COVID-19 and trends in other immunizations.

METHODS: We reviewed vaccination guidelines and available data for COVID-19, shingles, influenza, pertussis, and human papilloma virus (HPV) among 12+ age groups across the United States (US), England, Germany, Italy, France, Germany, and Australia. Based on data accessibility, we narrowed country list to US, England, Italy, Germany, and Australia, and then compared guideline-compliant country-level rates of vaccination from pre-pandemic (2018-2020) to during the pandemic and post-pandemic (2020-2023), and assessed for noticeable trends.

RESULTS: For influenza, data show an increasing trend, particularly during the 2020/2021 season, particularly among the elderly, and then a decrease in the 2021/2022 season with uptake on par with the 2019/2020 season. For other age groups the picture is less delineated. Differences across countries remained noticeable. There was a lack of identifiable trends across Shingrix, Tdap, and HPV vaccination pre-pandemic and post-pandemic, due to variations in available data, and an overall lack of available data in key national immunization strategies.

CONCLUSIONS: Our study demonstrated that opportunities remain to assess the pandemic’s impact on vaccine willingness. There is a clear lack of data to monitor vaccination trends for important immunization strategies like HPV and Shingrix. We encourage countries to collect and share this data.