The newest normal

Following a COVID-driven sales spike, immune supplement performance is returning to pre-pandemic levels.
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What goes up must come down. So it goes in the immune supplements category. At the height of the pandemic, sales skyrocketed. But now, fewer health concerns, product saturation and inflation have slowed consumer spending in both the adults’ and children’s segments.

Suppliers are not overly worried, recognizing that such growth was temporary and unsustainable. And there are bright spots, with some vendors citing health in their private label businesses, liquid and other “alternative” formats and cough/cold products containing immunity ingredients.

“During COVID, there was a huge sales increase and immunity played a big part, with the total category up about 20%,” said Chuck Tacl, SVP of sales and business development, Mason Vitamins. “Zinc took off like you wouldn’t believe, and vitamins C and D grew dramatically. Now, there’s an overall trade down.” 

Lou Machin, managing director, Lifelab Health, said the peak occurred about 19 months ago, when Covid-paranoid consumers were emptying shelves of immune supplements. “Every retailer was begging for more,” he added. “The market became glutted. Then, it kind of came back to earth and flattened out.”

According to Circana (formerly IRI and NPD), sales of vitamins (including immune supplements) grew 19.9% during the calendar year ending January 3, 2021, reaching $9.3 billion. For the period ending January 2, 2022, they increased another 6.7%, surpassing $9.9 billion. But for the 52 weeks ending March 3, 2023, sales declined to just below $9.7 billion. During this roughly two-year period, average unit price climbed from $10.94 to $12.23.

Sales of all children’s supplements fell 3.2% to $808 million for the 52 weeks ended March 26, 2023, indicated SPINS. The immune supplements segment, however, declined 16.1% to $11.6 million.

Coughing again

At the height of the pandemic, use of masks and sheltering in place dramatically reduced incidents of coughs and colds. But with restrictions lifted, people are again reaching for tissues. This has buoyed the cough/cold segment of immune supplements, giving suppliers additional placement in retailers’ cough/cold sections. 

“People are marketing cough/cold products with multiple immune ingredients,” said Tacl. “Over the past year, many have hopped into that arena. They’re trying to get into more areas beyond the vitamin section.”

Machin described last year as “epic” for colds and flu. Today, Lifelab is emphasizing Honeyworks, organic cough syrups and throat sprays made with honey plus anti-oxidant ingredients like zinc, ivy leaf extracts and melatonin. Children’s and adults’ formulations are available. “They’re clean products with no added ingredients,” he added.

While gummies have been very popular for some time, other “alternative” formulations are gaining ground. Two years ago, Mason launched all-natural stick powders. When placed in water and shaken, the stick dissolves. “It’s growing off a small base but outpacing the category,” said Tacl. The product is popular among people who take multiple supplements and develop “pill fatigue,” he added. 

The 14-serving packs include: Marine Collagen for skin health (biotin, hydraulic acid, turmeric and zinc); Immune Defense (electrolytes, elderberry, selenium and zinc); and Digest Guard, for immune support and gut health. 

Mason’s private labels are also performing well, partly driven by inflation. “With eggs and milk so expensive, there’s fewer items in the market basket with people purchasing more private label,” said Tacl.

“The pandemic raised awareness of maintaining health. People, especially parents, now understand the importance of supplementing children.”
— Geolyn Gonzalez, VP of sales and marketing, Total Resources International
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Healthy kids

The pandemic made parents more mindful than usual of their children’s health and more educated about immune supplements’ purported benefits. Now that COVID-19 has subsided, that education has generated ongoing interest in kids’ immune supplements. Products include labels specifically marketed for children and general market formulations that are safe for kids.

“The pandemic raised awareness of maintaining health,” said Geolyn Gonzalez, VP of sales and marketing, Total Resources International. “People, especially parents, now understand the importance of supplementing children.”

The cough/cold segment of children’s supplements did particularly well. Sales increased 4.9% to about $203 million, said SPINS. But parents are also concerned with more serious infections like influenza, RSV (respiratory syncytial virus) and Strep A [see sidebar], which have been on the rise. “While it’s normal for respiratory tract infections to spike in the colder months, levels and numbers of children’s hospitalizations last winter appeared unusual,” said Hannah Braye, head of technical advice at U.K.-based ADM Protexin. 

According to Kimberly Vigliante, SVP of wholesale and marketing, Piping Rock, vitamins C and D, immunity herb products, sleep aids and products for “gut health” are also popular for use by kids. While adults embrace them as well, potencies and recommended dosages are different. Adults may take 5 mg of melatonin, for example, but children often need just 1 mg, she added. Piping Rock offers melatonin gummies under its Just 4 Kidz line, part of its Nature’s Truth brand.

Braye said sleep issues can be symptoms of anxiety, stress and depression, which are rising among children. “American children are said by some to be in the midst of a mental health crisis,” she added.

Childlife Essentials offers Sleep Essentials, a melatonin-free alternative. L-theanine, a simple amino acid derived from tea (but without caffeine) and some mushrooms, is the key ingredient in this berry flavored herbal sleep aid.. Jamie Allen, marketing manager, also cited strength in zinc for kids.

Children’s digestive health supplements are growing, too, as more consumers recognize that strong immunity starts in the gut, where over 70% of immune cells reside, said Braye. Having the optimum balance of microflora is especially important in infants and children. “Research is indicating there’s a ’critical window’ in the first 1,000 days of life that can significantly affect immune system development,” she added. Braye also pointed to studies indicating that probiotics may reduce a child’s number of respiratory infections by almost half.

Suitable for babies, toddlers and young children, ADM’s Bio-Kult Infantis contains seven strains of beneficial bacteria as well as D3, omega-3 fatty acids and Preplex prebiotics. 

Products to help children concentrate and focus are trending, too. Nordic Naturals is emphasizing supplements containing docosahexaenoic acid (DHA). This omega-3 fatty acid is a primary structural component of the human brain, cerebral cortex, skin and retina. “There’s been so much emphasis on Vitamin C and elderberry,” said Brian Terry, director of sales. “Now, different categories are emerging.”

Beyond gummies

While some suppliers indicated ongoing strength in gummies, SPINS cited an 8.2% decline in overall children’s gummy sales for the 52 weeks ended March 26, 2023. In addition to being saturated with gummies, the market is diversifying. Sales of liquid supplements, for example, increased 5.7%; powders grew 9.7%.

“People are trying new things,” said Terry. “While gummies are big, we’re seeing other formats.” Nordic’s clean label children’s DHA comes in gummy, chewable soft gels (strawberry flavored) and liquid (for both children and babies) formulations. Children’s and babies’ DHA is also available in vegetarian versions.

Childlife, which has mainly supplied natural food stores, believes there are more opportunities for its bottled, liquid formats in food, drug and mass. It has developed cardboard packaging for some of its bottles (including elderberry), making them more amenable to these channels. It also offers soft chews.

“Our liquids are growing at the expense of gummies,” said David Levy, director of sales, who was hired two years ago to target these retailers. “People don’t want to give kids `candy.’ These sugar-free alternatives are easy to consume.” 

Piping Rock’s Just 4 Kidz focuses heavily on gummies. In addition to melatonin, it includes multivitamins/probiotics, black elderberry and vitamin C. It also has a chewable probiotic. “In kids’ vitamins, taste is everything,” said Vigliante.

While the market is unlikely to rebound to pandemic level sales, experts believe better performance is on the horizon once inflation ends and the market recovers from Covid-driven product saturation. “We don’t believe what’s happening now is a long-time trend,” said Tacl. 

    More sick kids

    Since COVID-19’s decline, cases of potentially serious respiratory illnesses have been rising. While most people do not become critically ill, the elderly and kids under age 5 are most likely to face health risks from bugs like influenza, respiratory syncytial virus and Strep A. 

    During the pandemic, severe group A strep infections declined about 25%. But during the fall of 2022, incidences of infection surpassed pre-COVID levels in some areas, particularly in children. Numbers of RSV cases also plummeted during the pandemic, said the CDC. But at the end of 2022, an RSV epidemic stressed the healthcare system with far more cases than usual. The CDC issued health advisories for both ailments in late 2022.

    According to the CDC, influenza hospitalizations per 100,000 population are highest among ages 65 and up followed by children ages 0 to 5. The scenario for RSV is somewhat similar. Invasive Group Strep A causes about 1,500 to 2,300 U.S. deaths annually, said the CDC. With Strep A, severe infections occur when bacteria invade blood or spinal fluid.

    Today, children may be more vulnerable to these ailments. In fact, some scientists theorize that children’s isolation during lockdown may have prevented them from developing immunities.

    “Children didn’t mix with other children as they normally would, meaning they may not have built up natural immunity,” said Hannah Braye, head of technical advice, ADM Protexin.

    In a way, this is good news for the kids’ immune supplements’ market since immunities take time to develop. “The pandemic may still play a role in growth of children’s immunity supplements, even years on,” she added.