Understanding the importance of staying current with COVID-19 vaccination is essential for protecting our most vulnerable population. The Australian experience with COVID-19 demonstrates the profound vulnerability of our older population. Most COVID-19 deaths occur in people aged over 80 years, highlighting the critical need for effective preventive measures in this age group. Adults aged 75 years and older face the highest risk of severe disease, hospitalisation, and death from COVID-19.

Current Australian vaccination recommendations

The Australian Technical Advisory Group on Immunisation (ATAGI) has developed specific guidance recognising these heightened risks. ATAGI recommends COVID-19 vaccine doses every 6 months for adults aged 75 years and older, including aged care residents. For adults aged 65 to 74 years, vaccination is recommended every 12 months, with eligibility for 6-monthly doses based on individual assessment following discussion with a healthcare provider.

Australian evidence of vaccine effectiveness

Compelling Australian research strongly supports the effectiveness of COVID-19 vaccines in older populations. A landmark study published in the Medical Journal of Australia examined vaccine effectiveness in Australians aged 65 years and older during August 2023 to February 2024. The findings were striking: the likelihood of death from COVID-19 was 74.7 per cent lower for people who had received XBB.1.5 vaccine boosters during the past 3 months compared to those who last received any booster more than 365 days ago.

The study, which followed 4.12 million Australian adults aged 65 and older, demonstrated that COVID-19 mortality rates were 72 per 100,000 person-years in people who received a COVID-19 booster more than 365 days earlier, compared to just 21 per 100,000 in those who received the XBB.1.5 vaccine within 3 months. This represents a substantial protective benefit that directly saves lives.

Importantly, this Australian research confirmed that vaccine effectiveness wanes over time. The relative vaccine effectiveness for a booster received within 3-6 months was 31.2 per cent, dropping to just 13.1 per cent for boosters received 6-12 months earlier. This evidence provides strong support for ATAGI’s recommendation that people aged 65 years and older are eligible to receive COVID-19 vaccine booster doses every 6 months.

Beyond acute illness: protecting against long COVID

The benefits of vaccination extend beyond preventing immediate illness. COVID-19 vaccination reduces the chance of suffering the effects of long COVID, which can develop during or following acute infection and last for an extended duration. For older Australians, who may already have multiple chronic conditions, avoiding the prolonged symptoms and functional limitations associated with long COVID is particularly important.

The aged care challenge in Australia

Despite clear recommendations and strong evidence, vaccination uptake in Australian aged care remains concerning. From the Department of Health, Disability and Ageing site – COVID-19 vaccination rates up to November 2025 show that in the last 6 months only 27 per cent of homes have more than 70 per cent of their residents vaccinated, while 37 per cent of homes have less than 40 per cent of their residents who have been vaccinated in the last 6 months, well below the level needed to protect this vulnerable population. This low uptake is particularly troubling given that residents in aged care facilities are among those at greatest risk.

Legal obligations and provider responsibilities

Under Australian aged care legislation, providers have clear obligations regarding COVID-19 vaccination. Residential aged care providers are responsible for facilitating timely access to vaccinations for their residents as soon as they are eligible. The Department of Health and Aged Care has written to every aged care facility in Australia to remind them of their obligations to keep residents safe and offer regular vaccinations.

The Aged Care Quality and Safety Commission actively monitors vaccination rates for each home and will act where required. This regulatory oversight reflects the critical importance of vaccination in protecting aged care residents and the legal duty of care providers owe to their residents.

Practical implementation in Australian aged care

For Australian aged care facilities, ensuring residents stay current with COVID-19 vaccination should be a cornerstone of infection prevention strategies. The vaccines have demonstrated excellent safety profiles in older Australians, with adverse events generally mild and well-tolerated.

Access should not be a barrier. COVID-19 vaccines remain free for all recommended and eligible individuals, including those without a Medicare card. Free COVID-19 vaccines can be accessed through GPs, pharmacists, community health centres, or Aboriginal health services. Many facilities arrange on-site vaccination clinics to ensure convenient access for all residents.

COVID-19 vaccines can be co-administered with other vaccines, including influenza vaccines, providing opportunities for efficient protection during routine vaccination sessions. There is no longer a requirement to wait a minimum time between a COVID-19 infection and having a COVID-19 vaccination, allowing for timely boosting when residents become eligible.

Moving forward: protecting older Australians

COVID-19 remains a year-round threat in Australia. For older Australians, particularly those in aged care settings, staying current with COVID-19 vaccination represents one of the most effective tools we have to prevent severe illness, hospitalisation, and death. The Australian evidence is clear: updated vaccines work, they’re safe, and they save lives.

As emphasised by Minister for Health and Ageing Mark Butler, “Regular vaccination helps reduce the risks of serious illness, hospitalisation or death from COVID-19.” Healthcare providers, aged care staff, and family members all play crucial roles in ensuring older Australians receive timely vaccination.

The message for Australian aged care is straightforward: residents aged 75 and older should receive COVID-19 vaccination every 6 months, while those aged 65-74 should receive vaccination at least every 12 months. These simple steps, supported by robust Australian evidence and clear regulatory requirements, can make a life-saving difference for our most vulnerable citizens.

By prioritising COVID-19 vaccination as part of comprehensive preventive care in aged care facilities, we can significantly reduce the burden of disease and help ensure that older Australians continue to live safely and maintain quality of life in their later years.

References

1. Australian Technical Advisory Group on Immunisation (ATAGI). ATAGI statement on the administration of COVID-19 vaccines in 2025. Australian Government Department of Health and Aged Care. April 2025

2. Liu B, Scaria A, Stepien S, Macartney K. Effectiveness of COVID-19 vaccine boosters for reducing COVID-19 mortality among people aged 65 years or older, Australia, August 2023 – February 2024: a retrospective observational cohort study. Med J Aust. 2025;223(8):374-380

3. Australian Immunisation Handbook. COVID-19. Updated December 5, 2025. Available at: https://immunisationhandbook.health.gov.au

4. Australian Government Department of Health and Aged Care. COVID-19 vaccination for aged care residents. Updated October 2025

5. Thompson M, Godbole G, Muller J, et al. Promoting aged care COVID-19 and influenza vaccination through education of Australian residential aged care staff. Vaccine. 2025;43(2):126492

6. Aged Care Quality and Safety Commission (https://www.health.gov.au/resources/publications/residential-aged-care-residents-covid-19-vaccination-rates-november-2025?language=en)

7. Australian Government Department of Health and Aged Care. Older Australians urged to get new Covid booster. Media Release. December 19, 2024

8. National Centre for Immunisation Research and Surveillance (NCIRS). Why is a COVID-19 booster important in 2025? May 2025

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