To minimise severe cases and deaths from COVID-19 among high-risk populations such as older adults (aged 60years 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 2023-24series vaccine. 192countries reported their use of COVID-19 vaccines for older people, of which 71vaccine products have been used for older adults and 79countries have deployed 22vaccines containing components against variants of concern; 122countries offered a second booster dose or a special booster dose, while others used only primary series or one booster dose. 96countries 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 2023-24series vaccination was 23·6% (6·6-52·4), with large differences by region. Coverage of the second booster and the 2023-24series was lower in individuals aged 60-70years than in older age groups. To achieve the WHO target of 100% coverage for older populations with primary series and a booster dose, 1·01doses per person are required, and to attain an 80%coverage for a second booster or 2023-24series, surpassing WHO's goal, 1·43doses 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.
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