ReviewAging clinical and experimental research2023
Exclusion of older adults and immunocompromised individuals in influenza, pneumococcal and COVID-19 vaccine trials before and after the COVID-19 pandemic.
Review in Aging clinical and experimental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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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
9 citing papers in PubMed, 23 citations in OpenAlex.
- Special Populations in Pivotal Clinical Trials: Eligibility and Supporting Evidence for Exclusion in EMA-Authorised Medicines.Clinical pharmacology and therapeutics · 2026Article
- Differentiating the COVID-19 Infection and Vaccine Experiences of Patients With Systemic, Single Organ, and Overlap Immune-Mediated Inflammatory Disease: Protocol for a Secondary Analysis for Enhancing COVID-19 Vaccine Pharmacovigilance.JMIR research protocols · 2026Article
- Real-world impact of NVX-CoV2373 COVID-19 vaccine in immunocompromised individuals in South Korea.BMC public health · 2026Article
- Patients know best: DESTINIES Patient Panel appraisal of a novel, risk-stratified approach to COVID-19 disease surveillance in the adult immunosuppressed.Oxford open immunology · 2026Article
- Populations Addressed in Vaccines Approved via the European Medicines Agency.Clinical pharmacology and therapeutics · 2025Article
- Article
- Musculoskeletal diseases, infections and vaccines: state of the art, research perspectives and educational needs.Aging clinical and experimental research · 2025Review
- A Response to: Letter to the Editor Regarding "Real-World Effectiveness of a Third Dose of mRNA-1273 Versus BNT162b2 on Inpatient and Medically Attended COVID-19 Among Immunocompromised US Adults".Infectious diseases and therapy · 2024Article
- A targeted approach to vaccine hesitancy.Oxford open immunology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 6 institutions in 6 countries.
Funding
Abstract
backgroundOlder adults and immunocompromised individulas are often excluded from vaccine trials.
aimWe hypothesised that during the coronavirus disease 2019 (COVID-19) pandemic, the proportion of trials excluding these patients decreased.
methodsUsing the US Food and Drug Administration and and European Medicines Agency search engines, we identified all vaccines approved against pneumococcal disease, influenza (quadrivalent vaccines), and COVID-19 from 2011 to 2021. Study protocols were screened for direct and indirect age exclusion criteria and exclusion of immunocompromised individuals. In addition, we reviewed the studies with no explicit exclusion criteria and investigated the actual inclusion of those individuals.
resultsWe identified 2024 trial records; 1702 were excluded (e.g., use of other vaccine or risk group); and 322 studies were eligible for our review. Among the pneumococcal and influenza vaccine trials (n = 193), 81 (42%) had an explicit direct age exclusion, and 150 (78%) had an indirect age-related exclusion. In total, 163 trials (84%) trials were likely to exclude older adults. Among the COVID-19 vaccine trials (n = 129), 33 (26%) had direct age exclusion and 82 (64%) had indirect age exclusion; in total, 85 (66%) trials were likely to exclude older adults. Therefore was a 18% decrease in the proportion of trials with age-related exclusion between 2011 and 2021 (only influenza and pneumococcal vaccine trials) and 2020-2021 (only COVID-19 vaccine trials) (p = 0.014). In a sub-analysis assessing observational and randomised trials, the decrease was 25% and 9%, respectively. Immunocompromised individuals were included in 87 (45%) of the pneumococcal and influenza vaccine trials compared with 54 (42%) of the COVID-19 vaccine trials (p = 0.058).
conclusionsDuring the COVID-19 pandemic, we found a decrease in the exclusion of older adults from vaccine trials but no significant change in the inclusion of immunocompromised individulas.
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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.