Dear AJPM reader,

As the world awaits a safe and effective COVID-19 vaccine, it seems especially timely to reflect on the tremendous successes and remaining challenges to vaccinations and immunization programming.

Several recently published AJPM articles—in addition to our Immunization collection—touch on points relevant to the debut of a COVID-19 vaccine. For example, Bartsch et al., in Vaccine Efficacy Needed for a COVID-19 Coronavirus Vaccine to Prevent or Stop an Epidemic as the Sole Intervention, ran simulation experiments that suggest a COVID-19 vaccine must have at least 70% efficacy to prevent an epidemic and at least 80% to end an epidemic without use of additional measures such as social distancing. 

However, research on vaccines in general reminds us that even a highly effective vaccine is not enough without sufficient levels of uptake, access, and outreach. In Characteristics of Repeated Influenza Vaccination Among Older U.S. Adults, for example, Bardenheier et al. found that adults who were non-smokers, non-Hispanic White, aged ≥60 years, and engaged with a medical provider had greater likelihood of repeatedly receiving influenza vaccination, while non-Hispanic Blacks and adults aged 51–59 years had lower likelihood of repeatedly receiving the vaccine. Lee and colleagues, in Rural–Urban Differences in Human Papillomavirus Vaccination Among Young Adults in 8 U.S. States, documented that rural young adults in those states are much less likely than urban young adults to have initiated the HPV vaccine.

Research by Tressler and co-authors touches on the impact of vaccine distribution settings. In Variations in Hepatitis B Vaccine Series Completion by Setting Among Adults at Risk in West Virginia, they found that vaccinating at-risk adults at local health department family planning clinics, correctional facilities, or substance abuse treatment centers may increase completion of the vaccine series, compared with focusing on sexually transmitted disease clinics as a setting for vaccine delivery.

In terms of outreach, Schwartz et al. found in Meningococcal Serogroup B Vaccine Policies and Recommendations at U.S. Colleges and Universities that many schools did not include information on serogroup B meningococcal vaccine in vaccination materials for students, suggesting a missed outreach opportunity.

In a global context, Bettampadi et al., in Vaccination Inequality in India, 2002–2013, documented that while childhood vaccination has improved overall in India, substantial socioeconomic and geographical disparities remain. Reflecting on this article, part of an upcoming supplement on global vaccination efforts, reminds us that achieving global equity in vaccine distribution will be an essential component of any strategy to bring the pandemic to an end.

As a group, these articles emphasize the important work beyond the lab that is necessary to implement a COVID-19 vaccine program that will successfully control and eventually end the pandemic.

We hope you find these, as well as our November 2020 articles, to be timely, topical, and informative.

Yours in prevention and health,


Matthew L. Boulton, MD, MPH
Editor-in-Chief

American Journal of Preventive Medicine