By Ethan Covey

Globally, more than 80% of total COVID-19 deaths in 2020 and 2021 occurred among people who were at least 60 years of age. However, in 2022, primary vaccination coverage among older adults fell substantially below World Health Organization goals, according to a report from the CDC.

Investigators used publicly available data on COVID-19 mortality for 2020 and 2021 to perform descriptive analyses, as well as the most current available COVID-19 vaccination coverage data from WHO to examine age-specific mortality and vaccination rollout, stratified by country World Bank income status (MMWR Morb Mortal Wkly Rep 2023;72[5]:113-118).

“As we enter the fourth year of the pandemic when many countries have ended mandated public health and behavioral measures to mitigate the spread of SARS-CoV-2, safe and effective COVID-19 vaccines—whether primary or booster doses—remain of particular importance for populations at risk to reduce mortality,” Man Kai Wong, MPH, an epidemiologist in the Global Immunization Division at the CDC’s Center for Global Health, told Infectious Disease Special Edition.

In July 2022, the WHO Strategic Advisory Group of Experts on Immunization Values Framework was updated to prioritize vaccination of populations at increased risk, including older adults, with the goal of 100% coverage with a complete COVID-19 vaccination series for at-risk populations.

The median reported completed primary series coverage among older adults in 2022 was 76%, with rates ranging from 33% in low-income countries to 90% in high-income countries. In 36 countries, coverage among older adults was the same or lower than that in the overall population.

The investigators noted two limitations of their report. The first was that data regarding age-disaggregated mortality and vaccination were self-reported by countries with different reporting frequencies, limited data verification processes and varying capacity for reporting current information. The second was that only data from 2020 and 2021 were included, not 2022; therefore, the direct association between COVID-19 mortality and vaccination coverage among older adults was not examined in the report. 

The investigators stated future research could be done with more regular reports and more availability of detailed data, including vaccination status for reported deaths. 

“This report clearly highlights that increased efforts, such as incorporating COVID-19 vaccination into routine primary care, are needed to increase primary series and booster dose coverage among older adults,” Mr. Wong said.


Mr. Wong reported no relevant financial disclosures.