Introduction: Older adults are at high risk of severe COVID-19 outcomes. Although COVID-19 booster vaccinations reduce disease severity and hospitalizations, many older adults are hesitant about receiving one. Our study aimed to identify the decisional needs of older adults considering COVID-19 booster vaccination. Method(s): We conducted a systematic review and used PRISMA reporting guidelines. Eligible studies reported decisional needs of people 60 years or older considering COVID-19 booster vaccinations. We searched five databases from December 2019 to October 2024. Two reviewers independently screened studies, extracted data, and assessed study quality. We used the Ottawa Decision Support Framework coding manual for descriptive analysis. Result(s): Of 5156 citations screened, nine studies were eligible. Studies were conducted in six countries (4 in China, 1 each in England, Israel, Malaysia, Saudi Arabia, and the United States) and involved 7684 adults aged 60 to 94 years old, with 56.9 % having chronic health conditions. In all studies, adults reported inadequate knowledge. Other decisional needs were: delay in acceptance of booster vaccination (3 China, 4 other countries); manifestation of decisional conflict (3 China; 3 other countries); inadequate support and resources from governments, healthcare authorities, healthcare professionals and family members (1 China; 4 others); and personal and health-related characteristics (chronic health condition) influencing their COVID-19 booster vaccination decision (3 China, 1 other). Discussion(s): Many older adults were hesitant about COVID-19 booster vaccinations. Common decisional needs were inadequate knowledge, inadequate support, and being concerns about the effect of vaccines on their chronic health conditions. Decisional needs of older adults considering COVID-19 vaccination could be addressed using decision support tools. Copyright © 2025
Abstract
Adults
Older adults
COVID-19
Acceptance
