As we grapple with a particularly harsh flu season, a simultaneous surge in COVID-19 cases has heightened concerns among public health experts and the wider population alike. Despite the clear and ongoing threat posed by these respiratory viruses, data from a recent nationally representative survey reveals a troubling trend: vaccination rates for both influenza and COVID-19 are alarmingly low among Americans aged 50 and older. This gap in immunization coverage threatens to undermine efforts to mitigate severe illness and strain on healthcare systems, particularly as viral mutations continue to challenge immune defenses.
The latest findings come from the University of Michigan National Poll on Healthy Aging, conducted between late December 2025 and mid-January 2026. The survey sampled nearly 3,000 adults aged 50 and above, evaluating vaccination status within specific time frames — flu vaccination within the last six months and COVID-19 vaccination within the past year. The poll uncovered that 42% of respondents had not received either vaccine during these periods, highlighting a significant portion of the older adult population vulnerable to these potent viruses. Contrastingly, only 29% had received both vaccines, while 27% had received only the flu shot.
Deepening the understanding of COVID-19 vaccination patterns reveals that nearly half of those surveyed reported it had been more than a year since their last COVID-19 dose, and a notable 15% have never been vaccinated against COVID-19 at all. This chronic under-vaccination presents a critical challenge for public health interventions, particularly as vaccines are continually updated to match the evolving viral strains. The poll’s insights into the reasons behind vaccine hesitancy provide valuable cues for targeted public health messaging and intervention.
Foremost among the reasons cited for foregoing updated immunizations was a perceived lack of necessity. Approximately 28% of individuals who skipped the flu shot and 29% who abstained from the COVID-19 vaccine cited the belief that vaccination was unnecessary. This misperception persists despite overwhelming evidence demonstrating that timely vaccination significantly reduces the risk of severe disease, hospitalization, and death, especially in older adults with waning or compromised immune responses. Vaccines act by priming the immune system with updated antigenic profiles reflective of the latest viral mutations, thus serving as essential “boosters” to maintain protective immunity.
Concerns about vaccine safety and efficacy were also prominent deterrents. Fears about adverse side effects were reported by 19% of those avoiding the flu vaccine and 27% abstaining from COVID-19 vaccines, underscoring the need for transparent communication around vaccine safety profiles. Similarly, doubts regarding the effectiveness of the vaccines deterred 18% and 19% of respondents for flu and COVID-19 vaccines, respectively. These data suggest an ongoing challenge in dispelling misinformation and rebuilding trust in vaccination’s protective benefits through evidence-based outreach.
Far fewer respondents indicated practical barriers such as forgetting to vaccinate or logistical hurdles including time, cost, or vaccine availability as their main reasons for lack of vaccination. This observation sharpens the focus of public health campaigns on informational and motivational dimensions rather than solely addressing access issues. The subtle but important distinctions in older adults’ decision-making processes highlight the need for nuanced strategies tailored to the cognitive and psychosocial contexts of this demographic.
Intriguingly, the survey also examined the potential impact of recent regulatory changes regarding COVID-19 vaccination recommendations. Following altered guidance by the U.S. Food and Drug Administration and Centers for Disease Control and Prevention, which limited recommendations in certain age groups, less than 1% of unvaccinated respondents cited ineligibility as a reason for non-vaccination. This finding suggests that the regulatory shifts did not significantly influence older adults’ vaccination behaviors. It also underscores the importance of clear, age-appropriate guidance that preserves protective measures for the highest-risk populations.
Age stratification within the survey data uncovered striking disparities in vaccine uptake. Individuals aged 75 and over, facing the highest severity risk from flu and COVID-19, showed significantly higher vaccination rates—46% for COVID-19 and an impressive 76% for flu vaccines—compared to younger cohorts. In contrast, only 20% of those aged 50 to 64 had received a recent COVID-19 vaccine, and 42% had the latest flu vaccination. This discrepancy points to missed opportunities in communicating the cumulative risks faced even by younger segments of the older adult population and suggests that protection messages must resonate with a broader age span.
Chronic health conditions emerged as a positive correlate with vaccine uptake. Those reporting at least one chronic illness were more likely to be vaccinated than their healthier counterparts. Nevertheless, a significant 39% of people with chronic conditions remain unvaccinated for either virus, indicating substantial room for improvement even among those most vulnerable. The data drives home the urgent need for healthcare providers to intensify tailored discussions and recommendations, leveraging regular clinical encounters to enhance immunization coverage.
Socioeconomic factors further compound disparities. Among those with household incomes under $60,000, 19% have never received a COVID-19 vaccine compared to 12% among higher-income groups. This income gradient highlights that vaccine hesitancy and access issues intersect intricately with broader social determinants of health, necessitating multi-faceted approaches that address economic and cultural barriers alike.
Importantly, experts emphasize that it is not too late to receive vaccinations this season. Given the dynamics of circulating viral strains, late vaccination can still confer meaningful protection. Moreover, for older adults and immunocompromised individuals who received initial COVID-19 vaccine doses early in the season, timely administration of second doses is critical to maintaining robust immunity. This layered immunity strategy, supported by current CDC adult vaccination schedules, underscores the complexity of immunization programs in a shifting viral landscape.
The data elucidated by the University of Michigan’s National Poll on Healthy Aging offers a vital window into the psychological, social, and demographic determinants shaping vaccine decisions among older Americans. It compels a reassessment of public health communication strategies to confront misconceptions, alleviate fears, and highlight the tangible personal benefits of vaccination. By fostering a deeper understanding of individual risk and promise of protection, it may be possible to reverse current trends and establish annual vaccination as an embraced norm—quelling the dual threats of influenza and COVID-19 in a highly vulnerable population.
Subject of Research: People
Article Title: Lagging Immunity: Why Older Adults Hesitate to Vaccinate Against Flu and COVID-19 Amid Rising Risks
News Publication Date: January 2026
Web References:
- University of Michigan Institute for Healthcare Policy and Innovation
- CDC Respiratory Viruses Risk Factors
- CDC Adult Vaccine Schedule
- CDC COVID-19 Vaccines for Immunocompromised People
Image Credits: Emily Smith – University of Michigan
Keywords: Vaccination, COVID-19 vaccines, Flu vaccines, Preventive medicine, Older adults, Health care policy
