MMWR Morb Mortal Wkly Rep. 2021 Feb 19;70(7):245-249. doi: 10.15585/mmwr.mm7007a4.
On March 13, 2020, the United States declared a national emergency concerning the novel coronavirus disease 2019 (COVID-19) outbreak (1). In response, many state and local governments issued shelter-in-place or stay-at-home orders, restricting nonessential activities outside residents' homes (2). CDC initially issued guidance recommending postponing routine adult vaccinations, which was later revised to recommend continuing to administer routine adult vaccines (3). In addition, factors such as disrupted operations of health care facilities and safety concerns regarding exposure to SARS-CoV-2, the virus that causes COVID-19, resulted in delay or avoidance of routine medical care (4), likely further affecting delivery of routine adult vaccinations. Medicare enrollment and claims data of Parts A (hospital insurance), B (medical insurance), and D (prescription drug insurance) were examined to assess the change in receipt of routine adult vaccines during the pandemic. Weekly receipt of four vaccines (13-valent pneumococcal conjugate vaccine [PCV13], 23-valent pneumococcal polysaccharide vaccine [PPSV23], tetanus-diphtheria or tetanus-diphtheria-acellular pertussis vaccine [Td/Tdap], and recombinant zoster vaccine [RZV]) by Medicare beneficiaries aged ≥65 years during January 5-July 18, 2020, was compared with that during January 6-July 20, 2019, for the total study sample and by race and ethnicity. Overall, weekly administration rates of the four examined vaccines declined by up to 89% after the national emergency declaration in mid-March (1) compared with those during the corresponding period in 2019. During the first week following the national emergency declaration, the weekly vaccination rates were 25%-62% lower than those during the corresponding week in 2019. After reaching their nadirs of 70%-89% below 2019 rates in the second to third week of April 2020, weekly vaccination rates gradually began to recover through mid-July, but by the last study week were still lower than were those during the corresponding period in 2019, with the exception of PPSV23. Vaccination declined sharply for all vaccines studied, overall and across all racial and ethnic groups. While the pandemic continues, vaccination providers should emphasize to patients the importance of continuing to receive routine vaccinations and provide reassurance by explaining the procedures in place to ensure patient safety (3).
2020 年 3 月 13 日，美国宣布因 2019 年新型冠状病毒病（COVID-19）爆发而进入全国紧急状态（1）。作为回应，许多州和地方政府发布了就地避难或居家令，限制居民在家外的非必要活动（2）。疾病预防控制中心最初发布了推迟常规成人疫苗接种的指南，后修订为建议继续进行常规成人疫苗接种（3）。此外，医疗机构运营中断以及对接触导致 COVID-19 的 SARS-CoV-2 病毒的安全担忧等因素导致常规医疗保健的延迟或避免（4），可能进一步影响常规成人疫苗接种的实施。检查了医疗保险 A 部分（医院保险）、B 部分（医疗保险）和 D 部分（处方药保险）的登记和索赔数据，以评估大流行期间常规成人疫苗接种的接受情况变化。比较了 2020 年 1 月 5 日至 7 月 18 日和 2019 年 1 月 6 日至 7 月 20 日期间，≥65 岁的 Medicare 受种者每周接受的 4 种疫苗（13 价肺炎球菌结合疫苗[PCV13]、23 价肺炎球菌多糖疫苗[PPSV23]、破伤风类毒素-白喉类毒素或破伤风类毒素-无细胞百日咳疫苗[Td/Tdap]和重组带状疱疹疫苗[RZV]）的情况，总研究样本以及按种族和民族进行比较。总体而言，与 2019 年同期相比，3 月中旬宣布全国紧急状态后，这 4 种疫苗的每周管理率下降了 89%（1）。在宣布全国紧急状态后的第一周，每周接种率比 2019 年同期低 25%-62%。2020 年 4 月的第二至第三周达到 2019 年接种率的 70%-89%以下的最低点后，每周接种率逐渐开始恢复，直到 7 月中旬，但在最后一个研究周，除 PPSV23 外，仍低于 2019 年同期。所有研究的疫苗接种率都急剧下降，总体和所有种族和族裔群体都是如此。随着大流行的继续，疫苗接种提供者应向患者强调继续接受常规疫苗接种的重要性，并通过解释为确保患者安全而采取的程序来提供保证（3）。
