SynthesisAgeing research reviews2021
Underrepresentation of older adults in clinical trials on COVID-19 vaccines: A systematic review.
Synthesis in Ageing research reviews, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Systematic review of research barriers, facilitators, and stakeholders in long-term care and geriatric settings, and a conceptual mapping framework to build research capacity.BMC geriatrics · 2023Pooled it
- COVID-19 vaccination effectiveness and safety in vulnerable populations: a meta-analysis of 33 observational studies.Frontiers in pharmacology · 2023Pooled it
- Efficacy, immunogenicity and safety of COVID-19 vaccines in older adults: a systematic review and meta-analysis.Frontiers in immunology · 2022Pooled it
- Exclusion by design: enrollment criteria limit older adult participation in SARS-CoV-2 vaccine clinical trials.Journal of clinical epidemiology · 2026Article
- Article
- Strict long COVID, symptom persistence, and functional decline among community-dwelling older adults in Quito, Ecuador: a cross-sectional study.BMC geriatrics · 2026Article
- Short-term safety and reactogenicity of same-day COVID-19 and influenza vaccination in very old, community-dwelling adults.European geriatric medicine · 2026Observational
- Article
- SOARNet: Establishing an older adult focused practice-based research network.Journal of clinical and translational science · 2026Article
- A scoping review of randomised controlled trials of vaccines that recruited care home residents: lessons for future trials.Age and ageing · 2025Article
- Evidence paradox: Enhancing clinical trials for older adults.The journal of nutrition, health & aging · 2025Article
- COVID-19 Vaccines Effectiveness and Safety in Trinidad and Tobago: A Systematic Review and Meta-Analysis.Microorganisms · 2025Review
- SARS-CoV-2 Vaccine-Induced Seroconversion and Immune Correlates in Patients with Hematological Malignancies. A Real World Study.Oncology research · 2025Article
- Generating and translating evidence for safe and effective medication management in aged care homes.British journal of clinical pharmacology · 2025Review
- New horizons in clinical practice guidelines for use with older people.Age and ageing · 2024Article
- Disentangling the reasons why older adults do not readily participate in cancer trials: a socio-epidemiological mixed methods approach.Age and ageing · 2024Article
- Effective interventions to increase representation of under-served groups in randomised trials in UK and Ireland: a scoping literature review.NIHR open research · 2024Article
- Potential determinants of antibody responses after vaccination against SARS-CoV-2 in older persons: the Doetinchem Cohort Study.Immunity & ageing : I & A · 2023Article
- Evaluating Demographic Representation in Clinical Trials: Use of the Adaptive Coronavirus Disease 2019 Treatment Trial (ACTT) as a Test Case.Open forum infectious diseases · 2023Article
- Exclusion of older adults and immunocompromised individuals in influenza, pneumococcal and COVID-19 vaccine trials before and after the COVID-19 pandemic.Aging clinical and experimental research · 2023Review
Corrections and comments
- Commented on by
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
During the COVID-19 pandemic older subjects have been disproportionately affected by the disease. Vaccination is a fundamental intervention to prevent the negative consequences of COVID-19, but it is not known if the needs and vulnerabilities of older people are adequately addressed by their inclusion in randomized clinical trials (RCTs) evaluating the efficacy of vaccines for COVID-19. Given this background, we aimed to evaluate if current and ongoing phase II-III RCTs evaluating the efficacy of COVID-19 vaccines included a representative sample of older people. A systematic literature search in PubMed and Clinicaltrials.gov was performed until May 01st, 2021. Among 474 abstracts initially retrieved, 20 RCTs (ten already published, ten ongoing) were included. In the ten studies already published, the mean age of participants was 45.2 ± 11.9 years and only 9.83% of the participants were more than 65 years, 1.66% more than 75 years and less than 1% (0.55%) more than 85 years. In the ten ongoing RCTs, many of the studies aimed at including participants older than 18 years, with one study including participants between 18 and 84 years, and two between 21 and 100 years. In conclusion, our systematic review demonstrates that in published and ongoing phase II-III randomized clinical trials evaluating the efficacy of COVID-19 vaccines only a tiny fraction of the most vulnerable group of older people was included, although they clearly were the first population that had to be vaccinated.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.