Post-Pandemic Vaccine Gaps Mirror Socioeconomic Disparities

COVID-19 vaccination has clustered in wealthier, more educated, and less crowded neighborhoods since the end of the pandemic emergency, according to a study in PLOS Global Public Health.¹ With vaccine rates and access disproportionately impacting underserved locations in the study, pharmacy is a key group within health care aligned to increase advocacy and improve uptake.

“Before COVID-19, vaccination disparities between Black and white populations were already growing, signaling that inequities in access and uptake were well established. The pandemic widened these gaps further,” according to the authors at the University of Washington.² “Rates for COVID-19, flu, and routine vaccines declined, driven by inconsistent public health guidance, unclear messaging about the purpose and effectiveness of booster doses, relaxed workplace mandates, and widespread misinformation.”

Research from the current study underscores that once the sense of immediate emergency faded, the influence of socioeconomic status on vaccine uptake returned. In cities like Talca and the La Serena/Coquimbo conurbation in Chile, the geospatial distribution of vaccines became significantly heterogeneous, with “high-high” clusters of doses corresponding with neighborhoods of higher educational attainment and less overcrowding.¹

Conversely, areas marked by high social vulnerability and overcrowding showed a stark “low-low” pattern of immunization. Interestingly, the distance to public health centers did not significantly influence these rates, suggesting that the problem is not merely geographic proximity but deep-seated structural determinants that generate durable inequities.

READ MORE: 2025-2026 COVID-19 Vaccines Cut Risk of Hospitalization Nearly in Half

This phenomenon is not isolated to Latin America. In the US, the Federal Retail Pharmacy Program (FRPP) became a cornerstone of the pandemic response, yet its data reveals similar sociodemographic trends. Although pharmacists administered nearly half of all COVID-19 doses in the US between 2020 and 2023, their contribution was notably higher in urban areas compared with rural ones, according to the Journal of the American Pharmacists Association.³

Specifically, FRPP providers administered 53% of doses in urban settings and only reached 42% in rural areas. This disparity mirrors the Chilean findings, where higher social vulnerability often translated to lower vaccine access, reflecting how geography and socioeconomic status produce downstream impacts on health outcomes.^1,3

For pharmacists, these trends highlight a need to evolve from mass-vaccination hubs into proactive community outreach partners.³

The consequences of these gaps extend far beyond COVID-19, as the pandemic imposed major disruptions on global immunization programs for other life-threatening diseases like measles, polio, and diphtheria. Globally, the population coverage of routine vaccines like the third dose of diphtheria, tetanus, and pertussis and polio suffered sharp declines, leaving millions of children unvaccinated.⁴

Lower-middle-income regions have been hit particularly hard, resulting in an alarming accumulation of “zero-dose” children who have not received even initial doses of basic childhood vaccines. This global instability makes the community-based collaborative model more vital than ever.

Innovative initiatives, such as a partnership involving the University of Maryland School of Pharmacy, demonstrated that vaccine uptake among underserved older adults can be improved by meeting people where they live. By collaborating with trusted nontraditional partners like Meals-on-Wheels to disseminate intake forms and offering immunizations in low-income senior housing and individual homes, pharmacists were able to overcome logistical hurdles like transportation and limited mobility.⁵

Despite these success stories, current data from the CDC indicates that maintaining uptake is a persistent challenge. As of mid-2026, the percentage of adults vaccinated with the most recent COVID-19 booster remains low at approximately 17.5%, and the rate for children lags even further behind at just under 10%.⁶

Similarly, the uptake for the respiratory syncytial virus vaccine among the high-risk population aged 75 and older is only around 43%. These low numbers emphasize the persistent barrier of misinformation, which researchers at the University of Washington identified as a major driver of hesitancy that has expanded skepticism from COVID-19 to routine childhood vaccines.^2,6

To reverse these trends, pharmacists must utilize their status as trusted health professionals to deliver clear, culturally competent education that addresses structural barriers such as food insecurity, housing instability, and much more. Only through territorially tailored strategies that account for local socioeconomic contexts can the health care system hope to achieve true, long-term immunization equity.^1-3

“The study provides useful insights for policymakers and public health officials who are responsible for designing more effective and equitable public health strategies worldwide. It demonstrates the complex transition from emergency vaccination to epidemic control to a long-term sustainable response through vaccination programs,” concluded the authors of the current study.¹ “Such a transition requires proactive, adaptive, and data-driven strategies to achieve equitable immunization. Consequently, vaccination strategies need to be adapted using a territorial approach, considering the complex relationships among socio-demographic factors and unique local contexts.”

READ MORE: COVID-19 Resource Center

REFERENCES

1. Ramírez-Santana M, Correa J, Rubilar P, et al. Geospatial disparities in post-pandemic SARS-CoV-2 vaccination: evidence from Chile beyond the national success. PLOS Glob Public Health. 2026;6(7):e0006808. doi:10.1371/journal.pgph.0006808

2. Reducing vaccine disparities for the urban underserved. University of Washington. Accessed July 28, 2026. https://www.washington.edu/populationhealth/research/reducing-vaccine-disparities-for-the-urban-underserved/

3. El Kalach R, Jones-Jack NH, Grabenstein JD, et al. Pharmacists’ answer to the COVID-19 pandemic: contribution of the Federal Retail Pharmacy Program to COVID-19 vaccination across sociodemographic characteristics-United States. J Am Pharm Assoc (2003). 2025 Jan-Feb;65(1):102305. doi: 10.1016/j.japh.2024.102305

4. Basu S, Ashok G, Debroy R, et al. Impact of the COVID-19 pandemic on routine vaccine landscape: a global perspective. Hum Vaccin Immunother. 2023 Dec 31;19(1):2199656. doi: 10.1080/21645515.2023.2199656

5. Brandt NJ, Hindman FM, Layson-Wolf C, et al. Expanding vaccination access in underserved communities across Maryland through a collaborative approach. JAPhA. 2025;65(4):102389. doi:10.1016/j.japh.2025.102389

6. Vaccination trends. CDC. July 24, 2026. Accessed July 28, 2026. https://www.cdc.gov/respiratory-viruses/data/vaccination-trends.html