BackgroundAge, race, ethnicity, and sex are important determinants of COVID-19 outcomes. Older adults (65 years and older) are at the highest risk of COVID-19 morbidity and mortality. Analyzing their vaccine uptake by subclassifying demographics is rare and can assist vaccination policies. This study investigates COVID-19 dose-one and two vaccine uptakes among them by race, ethnicity, and sex. MethodsImmunization registry data was used to calculate temporal changes in older adults’ COVID-19 vaccine uptake by race, ethnicity, race-sex, and ethnicity-sex in Kentucky’s most populous county, Jefferson County, during the first six quarters of the COVID-19 vaccination program. ResultsBy May 2022, the county’s Asian residents had the highest dose-one and two vaccination rates (97.0% and 80.4%), then White residents (90.0% and 80.2%). Black residents had one of the lowest COVID-19 vaccination rates (87.3% and 77.3%). The rate among Hispanic residents (82.0% and 66.4%) was considerably lower than non-Hispanic residents (90.2% and 80.1%). The rates were consistently lower in males. ConclusionsRacial, ethnic, and sex-based COVID-19 vaccine inequalities were largely maintained during the study period. Vaccine rollout practices and promotional programs should aim to boost the uptake of the COVID-19 vaccination among racial minority and male older adults.