Question explored with the scientific record
Should 68 year olds get the covid vaccine
The short version: for a 68-year-old, the evidence here favors vaccination against COVID death, but it is observational, conflicted, and the all-cause picture is genuinely contested.
The real risk this person faces is a bad COVID outcome. In an early-wave Spanish cohort of adults over 50, about 23 in 100 confirmed cases died, and fatality climbed with each added comorbidity [2]. That is the disease you are weighing against.
The benefit evidence is real but not clean. A Norwegian cohort of 4.6 million adults found fully vaccinated people 65+ died at roughly 42% the rate of the unvaccinated [5]. Australian data found bivalent boosters cut COVID death, strongest in the first 8 to 90 days and fading after [3]. Beijing data in adults 80+ found boosters cut in-hospital death by about 79% [6]. But these are observational, and the authors themselves flag healthy-vaccinee bias and unmeasured confounding [5][6].
The counter-case is serious. A reanalysis of the Australian study argues its mortality benefit is implausible, implying a 121% excess death rate in the unvaccinated that no OECD country approached [1]. A UK analysis found vaccinated all-cause mortality rising above unvaccinated over time [4]. Japanese data found lower mortality in the vaccinated 65-89 but higher in younger heavy-dose groups [7].
| Finding | What it shows | Weakness |
|---|---|---|
| Norway 65+ [5] | ~42% of unvaccinated death rate | Healthy-vaccinee bias |
| Australia bivalent [3] | Strong early, wanes by 91-180 days | Observational |
| Beijing 80+ [6] | ~79% lower in-hospital death | Residual confounding |
| Australia reanalysis [1] | Benefit implausible | Ecological |
| UK ONS [4] | Vaccinated mortality rose over time | Selection bias |
My call: for a healthy 68-year-old the benefit is modest and time-limited; for one with diabetes, heart, or lung disease the case is stronger, and the honest answer is that the all-cause data do not settle it. Confidence: low to moderate.
Sources used 7
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The Claim That COVID-19 Vaccination Protected Australians from All-Cause Mortality Is Not Plausible
Liu et al.'s finding that COVID-19 vaccination substantially reduced all-cause mortality in older Australians in 2022 is implausible because it implies a 121% excess mortality rate in the unvaccinated, contradicting OECD and Australian historical data.
DOI: 10.71189/jim/2026/v02n03a11 -
COVID19-related and all-cause mortality risk among middle-aged and older adults across the first epidemic wave of SARS-COV-2 infection: a population-based cohort study in Southern Catalonia, Spain, March–June 2020
In a retrospective cohort of adults over 50 in Camp de Tarragona, Spain, 536 laboratory-confirmed COVID-19 cases had a 23.1% case-fatality rate; case-fatality varied by comorbidity count, including among nursing-home residents.
DOI: 10.1186/s12889-021-11879-2 -
Effectiveness of bivalent COVID-19 boosters against COVID-19 mortality in people aged 65 years and older, Australia, November 2022 to May 2023
In Australians aged 65+, recently administered bivalent boosters reduced COVID-19 mortality more than ancestral monovalent boosters during Nov 2022–May 2023, with strongest protection within 8–90 days and waning thereafter.
DOI: 10.2807/1560-7917.es.2023.28.47.2300603 -
All-cause mortality according to COVID-19 vaccination status: An analysis of the UK office for National statistics public data
The analysis of UK ONS data from April 2021 to May 2023 found that all-cause and non-COVID-19 mortality SMRs increased over time for vaccinated individuals relative to unvaccinated individuals across all age groups, with predicted crossing points from September 2022 to January 2…
DOI: 10.12688/f1000research.154058.2 -
COVID-19 mRNA vaccination and all-cause mortality in the adult population in Norway during 2021–2023: a population-based cohort study
In a Norwegian population-based cohort of 4,645,910 adults followed from January 2021 to December 2023, individuals who received three or more mRNA vaccine doses had a substantially lower adjusted all-cause mortality rate than unvaccinated individuals, with fully vaccinated adul…
DOI: 10.1136/bmjph-2024-001859 -
Effectiveness of Inactivated COVID-19 Vaccination Against COVID-19–Related Hospitalization and Severe Outcomes in Adults ≥80 Years During Omicron Circulation in Beijing, China: Retrospective Cohort Study
During the 2022-2023 Beijing Omicron wave, booster vaccination in adults ≥80 years was associated with lower risk of COVID-19 hospitalization (VE 63.5%), severe/critical COVID-19 (66.9%), and in-hospital death (79.4%), though estimates may reflect residual confounding.
DOI: 10.2196/82915 -
Age-specific patterns of all-cause mortality across COVID-19 booster dose groups in two Japanese municipalities: an exploratory analysis
Exploratory analysis of Japanese municipal registry data found lower all-cause mortality among highly vaccinated adults aged 65-89 years but higher all-cause mortality among adults aged 20-49 years with ≥5 doses and those aged 50-64 with six doses, with causality unestablished.
DOI: 10.3389/fpubh.2026.1795437