Like other pandemics throughout human history, COVID-19 has caused profound changes that are still rippling through our societies, even as people are understandably eager to move on. In fact, these impacts are all the more dangerous when they are largely ignored or effectively invisible. The decline in adult vaccination may be one of the most significant, as a new report finds that ~100 million doses were missed in 2021 and 2022 alone – reversing global progress towards widespread adult immunisation as a new standard of care in a world of more old than young.