Why NOT take simple, safe steps to save your life?
It's not too late to get your flu and COVID shots, and RSV as well
Edited by Sadie Harley, reviewed
by Andrew Zinin
This winter's brutal flu season isn't over, and COVID-19
cases have risen recently too. But a new poll taken in recent weeks shows that
vaccination against both viruses lags among people 50 and over, and the
national survey reveals key reasons why.
In all, the University of Michigan National
Poll on Healthy Aging shows, 42% of people over 50 haven't gotten
either flu or COVID-19 vaccines in the past six months, though 29% have gotten
both and 27% have gotten just the updated flu shot.
The poll also asked about COVID-19 vaccination since it
became available in 2021: 49% of people over 50 said it's been more than a year
since their last dose, and 15% said they've never received it.
The leading reason people over 50 gave for not getting
updated vaccines?
They didn't think they needed them.
In all, 28% of people over 50 who didn't get a flu vaccine
in the past six months, and 29% of those who didn't get a COVID-19 vaccine in
the past year or ever, gave this as the main reason.
That's despite clear evidence showing that staying up to date on both vaccines
reduces the risk of serious illness and death in older adults, whose immune
systems need regular "reminders" with updated vaccines
tailored to recent mutations in the viruses.
Coming in second among reasons for not getting vaccinated
recently were worries about the vaccines' side effects (19% for flu and 27% for
COVID-19), followed by a belief that the vaccines aren't effective (18% and
19%, respectively).
Far fewer (10% for flu and 6% for COVID-19, respectively)
said they just didn't think of it. A few (4% and 3%) wanted to wait, and from
1% to 4% cited time, cost, insurance, availability, or eligibility concerns.
The findings could help health care providers and public health agencies communicate better with middle-aged and older adults about the health benefits of an annual vaccination and address any concerns, misinformation, or barriers.
The poll is based at the U-M Institute for Healthcare Policy
and Innovation.
From late December 2025 to mid-January 2026, the poll team
asked 2,964 U.S. adults age 50 and over if they'd gotten a flu vaccine dose in
the last six months, and when their most recent COVID-19 vaccination was. Then,
the team asked those who hadn't sought vaccination recently their main reason
why.
"The evidence is clear: These viruses can lead to
serious illness, hospitalization, and death. That risk increases with age and
underlying health conditions, and vaccination reduces that risk," said
Jeffrey Kullgren, M.D., M.P.H., M.S., the poll's director, an Associate
Professor of Internal Medicine at the U-M Medical School and a primary care
physician at the VA Ann Arbor Healthcare System.
"These findings suggest that we must do a much better
job helping people in their 50s and up understand that they will benefit from
getting these updated vaccines each year, that the vaccine side effects are
mild and short-lived, and that even if they later get infected and develop
symptoms, vaccination means they won't get as sick," he added.
Emphasizing individual impacts is important, he noted.
Experts and news stories often discuss vaccine
effectiveness in percentages based on how well the vaccine reduces the
risk of hospitalization or death in a population.
That's different from what an individual might care most
about: whether it will keep them from getting sick at all, or seriously ill,
Kullgren said.
Even when a vaccine isn't a perfect match for the virus
strains that are circulating, a recent dose still nudges the immune system to
be ready to fight off the virus in general, and can help reduce the severity
and duration of symptoms, he notes.
No impact from changed recommendation for COVID-19 shot
Last spring, leaders at the U.S. Food and Drug
Administration signaled a change in the agency's recommendation about which
adults should receive the COVID-19 vaccination. This was followed by an
official change in the FDA
approval and the recommendation from the Centers for Disease Control
and Prevention in late summer.
But the poll suggests this change didn't play a major role
in older adults' decision-making. Less than 1% of respondents who chose not to
get vaccinated against COVID-19 in the last year said their main reason was
they thought they weren't eligible.
And in fact, the federal change only affects some of those
who were polled: Those who are aged 50 to 64 without any chronic health
condition that raises COVID-19 risk.
COVID-19 vaccination is still recommended for most older
adults, including two doses a year for everyone over age 65 and anyone with a
compromised immune system, and one dose a year for those under 65 who have
underlying health conditions that put them at higher risk of severe COVID-19.
Many people ages 50 to 64 have at least one of those qualifying
conditions, which include diabetes,
asthma, obesity, high blood pressure, current or previous smoking, and physical
inactivity.
The CDC didn't change its recommendation that everyone over
the age of 6 months should get an annual flu vaccination. And major medical
societies and insurance companies announced that they would continue
recommending or covering both vaccines for all children over 6 months and all
adults, regardless of health status.
Differences in vaccination uptake
In addition to revealing reasons older adults didn't get
updated vaccines, the new poll data show some key differences in vaccination
among different groups of people 50 and over.
The oldest adults (age 75 and over)—those with the highest
risk of hospitalization and death from both viruses—had the highest rates of
updated vaccination.
In all, 46% of those age 75 and up said they had gotten a
COVID-19 vaccine in the last six months, compared with 37% of those aged 65 to
74 and 20% of those aged 50 to 64.
Flu vaccination was even higher in all age groups, with 76%
of those in the oldest age bracket having gotten the latest flu shot, compared
with 64% of those age 65 to 74 and 42% of those in their 50s and early 60s.
"This gap between flu and COVID-19 vaccination
represents an opportunity to connect the dots for older patients: both of these
viruses can put them at risk, both of them mutate rapidly, and both vaccines
should be an annual tradition, even if they don't get them at the same
time," said Kullgren.
He also points to the poll's positive finding that adults 50
and over who report having at least one chronic health condition were much more
likely to have gotten flu and COVID-19 shots recently than those without a
chronic condition.
But even among those with chronic health conditions, 39%
said they hadn't had either vaccine in the last six months, though this rate
was much lower than the 59% of those without chronic conditions who said so.
The poll also suggests a need for focus on those who have
never gotten vaccinated against COVID-19, as they grow older and their risk of
severe outcomes rises.
In all, 20% of those age 50 to 64 said they had never gotten
a COVID-19 vaccine, along with 12% of those age 65 to 75 and 7% of those age 75
and up.
There's also an income
gap, with 19% of all those with household incomes under $60,000 saying
they've never had a COVID-19 shot, compared with 12% of those with incomes over
$60,000.
Not too late to vaccinate, including second doses of
COVID-19 vaccine
Kullgren notes that it's not too late in the current
respiratory virus season for anyone to get a flu or COVID-19 vaccine if they
haven't already done so. It's also almost time for second doses of the COVID-19
vaccine for those over 65 or with moderately to severely compromised immune
systems who got this year's version soon after it arrived in early September.
They are recommended to get another dose starting six months after receiving
the first.
So, if someone received their first dose in the first week
of September, for instance, they can receive a second dose starting the first
week in February.
