Trends in adolescent and adult vaccination in pharmacy and medical settings in the United States, 2018-2024: a database study

Expert Rev Vaccines. 2025 Dec;24(1):53-66. doi: 10.1080/14760584.2024.2441255. Epub 2024 Dec 22.

Abstract

Background: Pharmacies can increase access to vaccines. This study aimed to describe trends in the proportion of adolescent and adult vaccinations administered in pharmacies in the United States from 2018 to 2024.

Research design and methods: This was a retrospective cross-sectional analysis of medical and pharmacy claims from commercial health insurance enrollees. We recorded vaccinations received by enrollees ≥9 years of age from 2018 to 2023 (routine vaccines) or 2024 (seasonal vaccines). We calculated the annual proportion of vaccinations occurring in pharmacies and the accumulated percent change in vaccination rate during each year from 2020 onward compared to 2018-2019.

Results: The proportion of routine vaccinations occurring in pharmacies was higher among adults than among adolescents. For most routine vaccines, this proportion increased during the study period. The lowest proportion was observed for adolescent human papillomavirus vaccination in 2018 (0.2%), and the highest for herpes zoster vaccination among adults ≥65 years of age in 2023 (88.6%). For all age groups, pharmacy-based vaccination was more common for seasonal influenza and SARS-CoV-2 vaccines than for all routine vaccines except herpes zoster.

Conclusions: Pharmacy-based vaccination is increasingly common in the United States, particularly among adults and for seasonal vaccines, and can help increase the overall level of vaccine uptake.

Keywords: Adolescents; COVID-19; United States; adults; pharmacies; vaccination.

Plain language summary

The uptake of seasonal and routine vaccines may be improved by offering vaccination in non-medical settings such as pharmacies. The convenience of pharmacy-based vaccination could help the United States recover from an ongoing vaccination deficit that began at the onset of the COVID-19 pandemic. This deficit is already contributing to surges in preventable acute infections such as measles and is predicted to increase the mortality and health care costs associated with serious long-term consequences of some infections, such as shingles and cervical cancer. The objective of the current analysis was to assess trends in the administration of recommended adolescent and adult vaccinations since 2018, with a focus on trends in administration in pharmacy and medical settings. This study found that pharmacy-based administration of almost all routine and seasonal vaccines generally became increasingly common during the study period (2018–2024). Seasonal vaccines were more commonly administered in pharmacy settings than all routine vaccines other than shingles, and pharmacy vaccination was generally more common among older age groups. Removing barriers to routine vaccination of all age groups in pharmacies could contribute to reversing ongoing COVID-19 pandemic-related vaccination deficits.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 / epidemiology
  • COVID-19 / prevention & control
  • COVID-19 Vaccines / administration & dosage
  • Child
  • Cross-Sectional Studies
  • Databases, Factual
  • Female
  • Humans
  • Influenza Vaccines / administration & dosage
  • Male
  • Middle Aged
  • Pharmacies / statistics & numerical data
  • Pharmacies / trends
  • Retrospective Studies
  • United States
  • Vaccination* / statistics & numerical data
  • Vaccination* / trends
  • Young Adult

Substances

  • COVID-19 Vaccines
  • Influenza Vaccines