The IQVIA Institute for Human Data Science released a new report at the 2023 Silver Economy Forum, Trends in Global Adult Vaccination: A View from Five Global Cities. The report, which was created in collaboration with GCOA and funded by GSK, explores the role of social and structural determinants of health in adult vaccine access and uptake across five global cities with strong data about their aging populations: Bangkok, Thailand; Brussels, Belgium; Chicago, US; Manchester, United Kingdom; and New York City, US.

The data demonstrate that vaccine use varies substantially even within a single city and suggest that policies, such as improved access to pharmacies or other points of vaccination, should be implemented to drive equitable access to adult immunization. Key findings include:

• In both Brussels and Manchester, easier access to pharmacies and other points of vaccination was associated with higher vaccine uptake, with additional factors in Brussels including access to transport and reimbursements for vaccines.

• In Bangkok, adult vaccine use within a district is correlated with the number of vaccination points, such as hospitals and clinics, as well as with indicators of economic growth in the district.

• In both New York City and Chicago, household income, education and median house value are highly correlated with vaccination rates across all vaccines studied. Race and ethnicity also play an important role in uptake in both cities, with white populations more likely to be vaccinated.

According to the report, optimal use of adult vaccines can be potentially enhanced with a focus on tracking adult vaccination data regularly at national and sub-national levels, ensuring financial considerations do not impact vaccine uptake, increasing the number of vaccinators, ensuring that vaccine policies account for sub-city level differences in vaccine use, and providing the basis for a growing and robust market that has incentives for ongoing innovation.