Vaccine Confidence: Where We Are Now and Where We Are Headed

Mar 02, 2023 | COVID-19 |


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This is the first episode of our new Vaccine Confidence series on At the Core of Care. Over the course of four episodes, we will dive into different facets of the COVID-19 vaccination effort, including education, advocacy, and community partnership. 

You can listen to At the Core of Care on the Pennsylvania Action Coalition’s website, or wherever you listen to podcasts. Stay tuned for the rest of the series in the coming weeks by following us on Twitter and subscribing to our newsletter.

In this episode, we hear from Nurses Who Vaccinate founder Melody Butler, RN, who works as an infection preventionist at Good Samaritan Hospital Medical Center on Long Island. Melody also joined us in 2021 for our first Vaccine Confidence series. This time, she’s back to talk about where we are in the pandemic, and to weigh in on whether we are more prepared to prevent cases of infectious disease than in previous years.

Melody starts by addressing the “tripledemic.” This winter, we have seen a simultaneous surge of COVID, RSV, and flu. Melody confirms that we are seeing higher-than-normal rates of infection. At the time of the recording—January 24th, 2023—there had been 85 pediatric deaths from flu this season, nearly double the number of deaths from last winter.

Meanwhile, COVID vaccination rates have plateaued. “Last we spoke, the vaccination rates for United States at the end of 2021 were about 73 percent for people having had received at least one dose of the COVID vaccine. And here we are in 2023 and we're at a whopping 81 percent of people having at least one vaccine dose. So, I'm very disappointed to see where we are right now” Melody says. The vaccination rate in children under five is only 11 percent.

"We know how to bring the rates of infection down and we know what we need to do in order to protect the most vulnerable in our communities. Unfortunately, not much has changed in regards to vaccination rates."
Melody Butler, RN, founder of Nurses Who Vaccinate


The conversation shifts to the bivalent booster rollout. Melody sees several reasons why not enough people are up-to-date with their vaccinations. First, many people do not know they’re eligible for a new vaccine, or forget they need a booster. People may be too busy to take off work to get the booster. When primary care doctors don’t provide the shot in their office and recommend going to a pharmacy, people may not schedule that extra appointment. Some people are afraid of the side effects, which can necessitate time off work. Many employers are being less lenient with giving time off than they were earlier in the pandemic.

The end of the Public Health Emergency Declaration is another threat to the vaccine rollout. Many services that are currently free, such as COVID tests, will no longer be free starting in May 2023. Millions of people may lose their Medicaid coverage this year, meaning lost pathways to free testing, vaccines, and treatments. Hospitals will no longer receive reimbursement for treating uninsured patients with COVID-19.

Overall, there is less support and more barriers keeping people from taking action against the spread of COVID-19. As Melody says, we are getting away from the “all hands on deck” mentality that we learned in the early days of the pandemic. The long-term management of COVID-19 and other infectious diseases is going to require employers and healthcare organizations to “highly encourage self-care.”

"When we talk about the emergency declaration ending, I'm really concerned. There's going to be major changes that are going to occur."
Melody Butler, RN, founder of Nurses Who Vaccinate


As the country moves on, nurses and other health professionals will have an uphill battle to prevent COVID cases. They will have to push against misinformation, especially as social media platforms change how they regulate misinformation. Nurses are also warding off “hopelessness” among patients, Melody claims. “People are very disappointed that the COVID vaccine does not prevent illness. We have to stress how amazing it is that the vaccine keeps you out of the hospital just like the flu shot…. that's such an important point that we need to stress to the public, to our patients, to our communities.”

Melody is the founding member of Nurses Who Vaccinate, an organization for nurses and healthcare workers who are passionate about vaccines. You can follow Nurses Who Vaccinate on Twitter or attend one of their upcoming events.

Nurses and other health professionals across the country are using innovative methods to vaccinate their communities against COVID-19. Follow along as we explore other professionals’ stories as part of our Vaccine Confidence Series.


Listen to all the episodes in the Vaccine Confidence Series:


This project was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention (grant number NU50CK000580). The Centers for Disease Control and Prevention is an agency within the Department of Health and Human Services (HHS). The contents of this resource center do not necessarily represent the policy of CDC or HHS, and should not be considered an endorsement by the Federal Government.



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About The Author

Annelise Slater is a Public Health Project Manager at the National Nurse-Led Care Consortium. 

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