Updated 2025-2026 COVID-19 Vaccine Nearly Halved ED Visits, Hospitalizations in CDC-Funded Study

Adults who received the 2025-2026 COVID-19 vaccine were substantially less likely to need emergency or urgent medical care for COVID-19, and far less likely to be hospitalized, than adults who did not receive the updated vaccine, according to interim findings published in JAMA Network Open. The CDC-funded analysis, conducted through the Virtual SARS-CoV-2, Influenza, and Other Respiratory Viruses Network (VISION), is among the first large-scale, real-world looks at how the reformulated vaccine—targeting the Omicron JN.1 lineage and its descendants—has performed since becoming available in September 2025.^1,2

Importantly, the investigators noted that this protection was layered on top of whatever immunity patients already carried from prior infection or earlier vaccine doses. As the study authors noted, adults can reduce their likelihood of severe COVID-19–associated outcomes by getting the updated vaccine.¹

How the Study Was Designed

Investigators used a test-negative design, a case-control method that has been used for decades to monitor seasonal influenza vaccines. Between September 3 and December 31, 2025, researchers identified 85,725 emergency department/urgent care encounters and 26,073 hospitalizations among immunocompetent adults with COVID-19–like illness across 253 ED/urgent care sites and 179 hospitals in 7 states. Patients who tested positive for SARS-CoV-2 were classified as cases, and those who tested negative served as controls; vaccine effectiveness (VE) was then calculated by comparing 2025-2026 vaccination rates between the 2 groups, adjusting for age, sex, race and ethnicity, calendar time, and geographic region.^1,4

According to Natalie Dean, PhD, a biostatistician from Emory University, and author of an accompanying study, because both cases and controls are drawn from individuals already seeking medical care, the approach helps offset—rather than worsen—the confounding that arises when health-conscious patients are more likely to be both vaccinated and tested.⁴

Effectiveness Held Up Across Age Groups

Among all adults 18 years and older, estimated VE was 50% (95% CI, 42%-57%) against COVID-19–associated ED/urgent care encounters and 55% (95% CI, 41%-66%) against hospitalization. Among adults 65 years and older, who face the highest risk of severe outcomes, VE was 48% against ED/urgent care visits and 53% against hospitalization. Only about 11% of patients in the ED/urgent care analysis and 12% in the hospitalization analysis had received the updated dose, with a median time since vaccination of just 6 to 7 weeks—underscoring how early these protective estimates are in the season.^1,4

European Data Tell a Similar Story

The findings track closely with a separate analysis from the Vaccine Effectiveness, Burden and Impact Studies (VEBIS) Primary Care Network, which evaluated 2025-2026 COVID-19 vaccine performance among older adults in France, Germany, Ireland, Italy, and Spain. That study estimated VE at roughly 59% against medically attended, symptomatic COVID-19 in the first 2 months after vaccination, with protection appearing to wane after. As in the US analysis, vaccine uptake in the European cohort was low, leading investigators to write that the gap represented “missed opportunities for preventing symptomatic COVID-19 among unvaccinated vulnerable groups.”³

A Study Almost Left Unpublished

According to Dean’s commentary, the Washington Post reported in April 2026 that the CDC had delayed and ultimately declined to publish the findings in its Morbidity and Mortality Weekly Report (MMWR)—despite VISION being a CDC-funded network built specifically for this kind of rapid vaccine monitoring. Jay Bhattacharya, MD, PhD, then the CDC’s acting director, raised objections to the study’s test-negative methodology and noted that MMWR is not a peer-reviewed publication.⁴

Dean then noted that the test-negative design “remains an important and practical approach” for routine vaccine surveillance and has long supported the CDC’s own seasonal influenza effectiveness estimates. The study was ultimately published, alongside Dean’s commentary, in the peer-reviewed JAMA Network Open.^1,4

What It Means for Pharmacists

For pharmacists counseling patients this season, the data offer a timely, evidence-based talking point, noting that even individuals with prior COVID-19 vaccination or infection can gain meaningful additional protection from the updated 2025-2026 vaccine, particularly against the outcomes that carry the greatest clinical and personal cost—emergency visits and hospital admissions. The low uptake documented in both the US and European analyses—just 11% and 12% in the VISION network, respectively—also points to a clear opportunity. As accessible, trusted points of care, pharmacists are uniquely positioned to close that gap, particularly among older adults and patients with chronic conditions who stand to benefit most.^1,3

REFERENCES

1. Wiegand RE, Chickery S, Yang D, et al. Interim Estimated Effectiveness of 2025-2026 COVID-19 Vaccines in Adults Using a Test-Negative Design. JAMA Netw Open. 2026;9(6):e2625152. doi:10.1001/jamanetworkopen.2026.25152

2. Rudd T. JAMA Journal Publishes COVID Vaccine Study Squelched by CDC Leader. News release, MedPageToday. June 23, 2026. Accessed June 26, 2026. https://www.medpagetoday.com/infectiousdisease/covid19vaccine

3. Bergeson L. Study suggests 2025-26 COVID vaccine cuts emergency, urgent care visits by half. News release. University of Minnesota. June 23, 2026. Accessed June 26, 2026. https://www.cidrap.umn.edu/covid-19/study-suggests-2025-26-covid-vaccine-cuts-emergency-urgent-care-visits-half

4. Dean N. Why the Test-Negative Design Is Used for Routine Vaccine Monitoring. JAMA Netw Open. 2026;9(6):e2625157. doi:10.1001/jamanetworkopen.2026.25157