Publication date: Jul 24, 2025

In 2023, adults ≥60 years old were eligible to receive updated influenza and COVID-19 vaccines along with newly available respiratory syncytial virus (RSV) vaccines. Vaccine acceptance for influenza is typically high among this age cohort. We assessed COVID-19 and RSV vaccine uptake among influenza vaccine recipients to identify sociodemographic disparities among California adults ≥60 years old who did not receive all three vaccinations. We used a cross-sectional design to assess the prevalence of COVID-19 and RSV vaccination among California adults ≥60 years old with an influenza vaccination reported to the California Immunization Registry during 08/01/2023-06/30/2024. We used log binomial regression to calculate prevalence ratios (PR) and 95 % confidence intervals (95 %CI) that measured associations between recipient sociodemographic characteristics and receipt of all three vaccines. Among 4,471,042 adults included in this study, 901,815 (20 %) received all three vaccinations during 2023-2024. The prevalence for receiving COVID-19 and RSV vaccines among Latino adults residing in the lowest resource communities was 80 % less (PR: 0. 20, 95 %CI: 0. 19, 0. 20) than among white adults residing in the highest resource communities when the vaccination status of the comparison group was limited to influenza only vaccine recipients. We identified concerning disparities in the uptake of COVID-19 and RSV vaccines among older adults during the 2023-2024 respiratory virus season in California. Provider awareness of these disparities may help improve vaccine uptake among older adult populations when patients seek their seasonal influenza vaccinations.

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