Many of the people most at risk of dying aren’t getting COVID shots.

For years now, health experts have been warning that COVID-era politics and the spread of anti-vaxxer lies have brought us to the brink of public-health catastrophe—that a Great Collapse of Vaccination Rates is nigh. This hasn’t come to pass. In spite of deep concerns about a generation of young parents who might soon give up on immunizations altogether—not simply for COVID, but perhaps for all disease—many of the stats we have are looking good. Standard vaccination coverage among babies and toddlers, including the pandemic babies born in 2020, is “high and stable,” the CDC reports. And kindergarteners’ immunization rates, which dipped after the pandemic started, are no longer losing ground.

Whatever gaps in early childhood vaccination were brought on by the chaos of early 2020 have since been reversed, Alison Buttenheim, a professor of nursing and health policy at the University of Pennsylvania, told me: “We’ve substantially caught up, which is incredible. It’s actually an amazing feat.”

But even in the shadow of this triumph, a more specific crisis in vaccine acceptance has emerged. Americans aren’t now suspicious of inoculations on the whole—the nation isn’t anti-vax—but we have lost faith in yearly COVID shots. Barely any children have been getting them. Among adults, the drop in uptake has been rapid and relentless: By the spring of 2022, 56 percent of all adults had received their initial booster shot; a year later, just 28 percent were up to date; so far this COVID season, just 19 percent can say the same.

Of course, the dangers from infection have been dropping too. Almost all of us have been exposed to COVID at this point, either through prior immunization, natural infection, or—most likely—both. That makes the disease much less deadly than it’s ever been before. (Among kids, the CDC now attributes “0.00%” of weekly deaths to COVID.) But for one age group in particular—people over 65—the crashing vaccination rates should inspire dread. More than 1,500 deaths each week are still associated with COVID, and almost all of them are senior citizens; current data hint that COVID has been killing seniors at seven times the rate of flu. Across the nation’s nursing homes and retirement communities, the Great Collapse is real.

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