The coronavirus disease 2019 (COVID-19) vaccine effectively reduces the possibility of severe illness and mortality in older adults and is essential for controlling the epidemic. Compared with developed countries, the coverage of full vaccination and booster vaccination for older adults aged 60 or above in China is poor, making it urgent to accelerate their vaccination in China. We discussed potential reasons for low vaccination coverage for older adults aged 60 or above and presented strategies to promote their COVID-19 vaccination in China.

As of July 2022, COVID-19 has caused more than 560 million cases and 6 million deaths worldwide (1). Compared with other age groups, older adults aged 60 or above are at a higher risk of severe illness and death after COVID-19 infection due to weak immune function and comorbidities (2). China began opening COVID-19 vaccination for older adults in April 2021, following the first phase of emergency vaccination for people in high-risk and critical positions and the second phase of mass vaccination for adults aged 18–59. The COVID-19 vaccine is available for free regardless of residency. Although the government emphasized promoting vaccination for older adults at the end of 2021, COVID-19 vaccination coverage continued inching upward but at a slowing rate from January to June 2022, especially for a booster vaccination (Figure 1). As of August 10, 2022, the full vaccination rate was 85.6% and the booster vaccination coverage was only 67.8% for older adults in China, that were lower than those in countries like the United States (92.1%, 70.7%), Germany (91.2%, 85.9%), and Japan(92.4%, 90.3%). The Omicron wave in Shanghai and nationwide further highlights the urgency of vaccination for older adults. In China, the poor vaccination coverage among older adults is found for COVID-19 vaccine as well as general routine vaccines. There is usually insufficient awareness of general vaccines among older adults. Prior to the COVID-19 pandemic, there was a lack of publicity about vaccination and vaccines were generally self-paid for older adults, leading to low awareness and