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Letters to the Editor

CDC Recommends Concurrent Immunizations

Does the COVID-19 Vaccination Campaign Offer Opportunities for Improving Vaccination Rates Across the Lifespan?

Rotheram-Borus, Mary Jane PhD; Rotheram-Fuller, Erin PhD

Author Information
Infectious Diseases in Clinical Practice: July 2021 - Volume 29 - Issue 4 - p e259
doi: 10.1097/IPC.0000000000001020
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To the Editor:

Over the next year, there will be major marketing campaigns and, hopefully, high motivation by the public to take the 2 doses of the COVID-19 vaccine. Although the pandemic has devastated communities, this large-scale vaccination program may offer public health officials and physicians an opportunity to improve the national rates of immunization at every age level. In particular, adolescents and older adults may significantly benefit by bundling COVID-19 vaccinations with other age-recommended vaccinations, as recommended by the Centers for Disease Control and Prevention (CDC).1

Immunization rates in the United States are relatively high for children younger than 3 years: approximately 70% of children complete the 7 recommended vaccinations by the age of 3 years.2 This rises to approximately 95% by kindergarten.3 However, vaccination rates among adolescents are only approximately 54.2%, and drops by approximately 10% nationally for young people not in metropolitan service areas and for both low-income and African American and Latino youths.4 In particular, human papillomavirus (HPV) immunizations require 3 doses. Although 71.5% of young people initiate the HPV series, only 51% complete the series.4 COVID-19 immunizations currently require 2 doses; linking HPV to these COVID-19 immunizations may result in significantly more young people completing the series.

Perhaps those most likely to complete the COVID-19 vaccinations are the elderly, who are at risk for having the most serious consequences of the COVID-19 infections.5 Only 34.5% of older Americans receive the shingles vaccine, 63.6% complete the pneumococcal vaccinations, and 69% complete influenza immunizations in the last 12 months.6 The broad national initiative to protect the elderly from COVID-19 could also serve as an opportunity to protect the elderly from other diseases.

Although the personal tragedies and economic consequences of COVID-19 have been devastating, the upcoming immunization rollouts may offer opportunities for Americans to protect their health from multiple existing health threats. It will take more coordination to prepare and coordinate vaccine doses at clinic and community sites than when administering only 1 vaccination. However, there are several months before the rollout is fully powered to deliver the vaccine, and many clinics serve patients within a narrow age range, reducing the complexity of implementing a multivaccine immunization. The CDC, state and local policy makers, and insurance providers are encouraged to consider opportunities created by this pandemic.

Mary Jane Rotheram-Borus, PhD
University of California Los Angeles Los Angeles, CA [email protected]
Erin Rotheram-Fuller, PhD
Arizona State University Tempe, AZ


1. Centers for Disease Control and Prevention. Multiple vaccinations at once. U.S. National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion. 2017. Available at: Accessed December 27, 2020.
2. Hill H, Elam-Evans L, Yankey D, et al. Vaccination coverage among children aged 19–35 months—United States, 2017. MMWR Morb Mortal Wkly Rep. 2018;67(40):1123–1128.
3. Seither R, Loretan C, Driver K, et al. Vaccination coverage with selected vaccines and exemption rates among children in kindergarten—United States, 2018–19 school year. MMWR Morb Mortal Wkly Rep. 2019;68(41):905–912.
4. Elam-Evans L, Yanker D, Singleton J, et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2019. MMWR Morb Mortal Wkly Rep. 2020;69(35):1109–1116.
5. Rossen L, Branum A, Ahmad F, et al. Excess deaths associated with COVID-19, by age and race and ethnicity—United States, January 26–October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(42):1522–1527.
6. Centers for Disease Control and Prevention. Vaccination coverage among adults in the US, National Health Interview Survey, 2017. In: National Center for Immunization and Respiratory Diseases. Available at: Accessed December 27, 2020.
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