Trends in vaccination in pharmacy and medical settings among Medicaid recipients in the United States, 2018–2023: a claims analysis

BACKGROUND: Medicaid beneficiaries typically have low vaccination rates, in part due to limited access. Pharmacies provide easy-to-access locations for vaccination. RESEARCH DESIGN AND METHODS: This was a retrospective analysis of trends in pharmacy-based vaccination by age and race or ethnicity among Medicaid recipients aged ≥9 from 1 January 2018 (before the COVID-19 pandemic) to 31 December 2023. The percentage of all vaccinations administered at pharmacies and the overall percentage change in vaccination rates were determined. RESULTS: With some exceptions, overall routine and seasonal vaccination rates remained lower in 2023 than in 2018-2019. This was observed for human papillomavirus (HPV), influenza, and tetanus-containing (Tdap/Td) vaccines in adolescents and for hepatitis A, influenza, meningococcal, pneumococcal, and Tdap/Td vaccines in various adult age groups. The percentage of routine and seasonal vaccinations administered at pharmacies increased over the study period among adults, with increases of 5.2-17.5 percentage points for hepatitis A, hepatitis B, HPV, meningococcal, pneumococcal, and tetanus-containing vaccines among those aged 19-49. Across age groups, pharmacy-based vaccination was most frequent in White enrollees, followed by Black and then Hispanic enrollees, with smaller differentials in adults aged ≥65. CONCLUSIONS: Generally overall vaccine administration rates declined in Medicaid beneficiaries; however, the proportion administered at pharmacies increased.