In 2022, the median global COVID-19 vaccination rate among people aged 60 and older—who make up over 80% of deaths from the virus—was 76%, substantially lower than the World Health Organization (WHO) goal of 100%, according to a study today in Morbidity and Mortality Weekly Report. Low- and middle-income countries (LMICs) had particularly low uptake.
Researchers from the US Centers for Disease Control and Prevention and the WHO parsed data on COVID-19 deaths in 2020 and 2021 and recent vaccine coverage data to estimate death rates and vaccine uptake among people 60 and older by country and World Bank income status.
In fall 2020, the WHO published a plan for prioritizing COVID-19 vaccination, followed by a strategy brief in October 2021 and a July 2022 update prioritizing at-risk people, including older adults. The goal was 100% coverage with a complete COVID-19 vaccine series for this group by mid-2022.
10 times more excess deaths in LMICs
Surveillance and weekly reports documented 5.4 million and 2.5 million COVID-19 deaths in 2020 and 2021, respectively. The WHO model showed an estimated 14.9 million excess deaths. People 60 and older made up 80% of COVID-19 deaths reported through surveillance and 82% of deaths from the WHO's model.
In 73% of low-income countries and 31% of lower–middle-income countries (mostly in the WHO's African, Eastern Mediterranean, and European regions), estimated excess mortality was more than 10 times higher than the total deaths reported through surveillance, while most high-income countries saw a doubling of excess deaths.
Upper- and lower–middle–income countries accounted for 81% of excess deaths among people 60 and older, and lower–middle–income countries made up 52% of excess deaths in this age-group (annual excess death rate, 1,039 per 100,000 people).
Despite the heavy burden, the median 2022 vaccination rate in the over-60 group was 76% (range, 33% in low-income countries to 90% of those with higher incomes). "Increased efforts are needed to increase primary series and booster dose coverage among all older adults," the researchers wrote.