Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health, Nanjing Medical University, Nanjing, China.
Lancet Healthy Longev. 2024 Nov;5(11):100646. doi: 10.1016/j.lanhl.2024.100646. Epub 2024 Nov 7.
To minimise severe cases and deaths from COVID-19 among high-risk populations such as older adults (aged 60 years and older), it is crucial to monitor and update vaccination strategies. In this study, we aim to provide a global profile of the current COVID-19 vaccination programmes for older adults, including vaccination policies, coverage rates, and vaccine demand.
We used publicly available data on the COVID-19 vaccines used, vaccination schedules, indicated age groups, and age-specific country-level vaccine coverage, updated through to July 20, 2024. Data on vaccination policy were extracted from publicly available sources in the following priority: (1) official sources (ie, government websites, health department websites, and official reports); (2) resources integrated by institutions or organisations (ie, European Center for Disease Prevention and Control, Africa Center for Disease Prevention and Control, and COVAX); and (3) cross-validated news and media reports derived from government or health department sources. We estimated coverage gaps to achievement of two specific objectives: (1) immunising 100% of older adults with primary series and a booster dose, as per WHO's goal; and (2) surpassing WHO's goal by administering one extra booster dose to 80% of older adults or achieving 80% coverage of a 2023-24 series vaccine.
192 countries reported their use of COVID-19 vaccines for older people, of which 71 vaccine products have been used for older adults and 79 countries have deployed 22 vaccines containing components against variants of concern; 122 countries offered a second booster dose or a special booster dose, while others used only primary series or one booster dose. 96 countries prioritised older people for vaccination. Among countries with available data, the median proportion of individuals completing a primary series was 81% (IQR 58·3-92·0), for a first booster was 53% (14·1-81·7), for a second booster was 44·3% (13·5-69·7), and for a 2023-24 series vaccination was 23·6% (6·6-52·4), with large differences by region. Coverage of the second booster and the 2023-24 series was lower in individuals aged 60-70 years than in older age groups. To achieve the WHO target of 100% coverage for older populations with primary series and a booster dose, 1·01 doses per person are required, and to attain an 80% coverage for a second booster or 2023-24 series, surpassing WHO's goal, 1·43 doses per person are required.
Progress of COVID-19 vaccination programmes for older adults is uneven across countries, emphasising an ongoing challenge to achieve vaccine equity for this high-risk age group. Therefore, it is essential to establish robust and timely vaccination surveillance systems, especially to facilitate data-driven policies that promote COVID-19 vaccination campaigns worldwide.
Key Program of the National Natural Science Foundation of China.
为了降低 COVID-19 在高危人群（如 60 岁及以上老年人）中的严重病例和死亡人数，监测和更新疫苗接种策略至关重要。本研究旨在提供全球范围内针对老年人的 COVID-19 疫苗接种计划概况，包括疫苗接种政策、接种率和疫苗需求。
我们使用了截至 2024 年 7 月 20 日的 COVID-19 疫苗使用情况、接种计划、指示年龄组和特定年龄组国家层面疫苗覆盖率的公开可用数据。接种政策数据从以下优先级别的公开来源中提取：（1）官方来源（即政府网站、卫生部门网站和官方报告）；（2）机构或组织集成的资源（即欧洲疾病预防控制中心、非洲疾病预防控制中心和 COVAX）；（3）源自政府或卫生部门来源的交叉验证新闻和媒体报道。我们估计了实现两个具体目标的覆盖率差距：（1）按照世界卫生组织的目标，为所有老年人接种初级系列和加强针；（2）通过为 80%的老年人接种额外的加强针或实现 2023-24 系列疫苗 80%的覆盖率，超过世界卫生组织的目标。
192 个国家报告了其为老年人使用 COVID-19 疫苗的情况，其中 71 种疫苗产品已用于老年人，79 个国家已部署了 22 种含有针对关注变异株成分的疫苗；122 个国家提供了第二加强针或特殊加强针，而其他国家仅使用初级系列或一剂加强针。122 个国家优先为老年人接种疫苗。在有可用数据的国家中，完成初级系列接种的个体中位数比例为 81%（IQR 58·3-92·0），第一剂加强针为 53%（14·1-81·7），第二剂加强针为 44·3%（13·5-69·7），2023-24 系列疫苗接种为 23·6%（6·6-52·4），区域差异很大。60-70 岁人群的第二加强针和 2023-24 系列疫苗接种覆盖率低于较年长年龄组。要实现世界卫生组织为所有老年人接种初级系列和加强针的 100%覆盖率目标，每人需要 1.01 剂疫苗，要实现超过世界卫生组织目标的 80%第二加强针或 2023-24 系列疫苗接种覆盖率，每人需要 1.43 剂疫苗。
各国 COVID-19 老年人疫苗接种计划的进展参差不齐，突显了为这一高风险年龄组实现疫苗公平性的持续挑战。因此，建立健全和及时的疫苗接种监测系统至关重要，特别是要促进数据驱动的政策，在全球范围内推动 COVID-19 疫苗接种运动。
国家自然科学基金重点项目。
