According to researchers at the University of Aberdeen in Scotland, people living in older care homes have been largely excluded from vaccine trials, despite being among the groups most likely to receive vaccines, especially during public health emergencies. Researchers say this mismatch has limited the evidence available on how vaccines perform in care nursing home populations, where residents are often older, frailer, and living with multiple poor health conditions.1
This issue is highlighted in a new academic review published in 2025 in the journal Age and Ageing, which examined vaccine trials that included older adults living in care homes. The review found that few clinical trials have involved this population, raising questions about how well existing data on vaccine safety and effectiveness reflects the people most affected by infectious disease outbreaks.2
Professor Roy Soiza, Honorary Chair at the University of Aberdeen and Consultant Geriatrician at National Health Service (NHS) Grampian who led the project, said:
As demonstrated during the COVID-19 pandemic, care home residents are often worst affected by infectious diseases, so numerous vaccines are developed for older people with frailty, including care home residents. Despite this, care home residents are often excluded from trials of medications that are later prescribed to them, including vaccines. During the pandemic, not a single care home resident was recruited into trials despite this group being prioritised for vaccination.3
The study was funded by Moderna and supported by the National Institutes of Health and Care Research (NIHR) in the United Kingdom.4
Limited Evidence From Care Home Settings
The researchers initially identified 701 vaccine-related articles, but only 20 studies met the criteria for including care home residents in randomized controlled trials. Those trials involved 7,479 residents across 238 care homes, a relatively small evidence base given the size of the care home population. Most of the trials focused on influenza vaccines, while only three examined pneumococcal vaccines. Participants had a weighted mean age of just over 82 years. The review found little recent trial evidence involving care home residents, despite ongoing vaccination programs targeting this group.5
Ethical Concerns Around Inclusion in Vaccine Trials
The review highlighted ethical considerations linked to the inclusion of care home residents in vaccine trials, particularly given the practical and consent-related barriers. Many residents were screened but did not ultimately participate, with around 70 percent of assessed individuals excluded in studies that reported screening data.6
Obtaining informed consent was a central concern. A high proportion of care home residents live with cognitive impairment, which can complicate the informed consent process among the elderly patients. In one U.K. study included in the review, most screening failures were attributed to difficulties in securing consent rather than medical ineligibility.7
Practical constraints also raised ethical questions. Some care homes were difficult to evaluate, while routine vaccination schedules and staffing pressures reduced opportunities for research participation. Researchers suggested that these factors can reinforce cautious approaches to study participant recruitment, further complicating decisions about whether or how to include care home residents in trials.8
Implications for Future Vaccination Decisions
Researchers say the limited inclusion of care home residents has consequences for how vaccine data is interpreted and applied. Older adults in care homes often differ from community-dwelling older adults in terms of health status, medication use, and immune response, meaning findings from broader trials may not fully translate to this setting.9
The review suggests that future trials could address these concerns by working more closely with care home staff, involving families earlier in informed consent discussions, and designing studies that better accommodate residents with cognitive impairment.10
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Click here to view References:1 University of Aberdeen. Vaccine trial review finds that future vaccine trials must include care home residents. Jan. 20, 2026.
2 Subbarayan S. et al. A scoping review of randomised controlled trials of vaccines that recruited care home residents: lessons for future trials. Age and Ageing 2025; 54(12).
3 University of Aberdeen. Vaccine trial review finds that future vaccine trials must include care home residents. Jan. 20, 2026.
4 Ibid.
5 Subbarayan S. et al. A scoping review of randomised controlled trials of vaccines that recruited care home residents: lessons for future trials. Age and Ageing 2025; 54(12).
6 Ibid.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
2 Responses
But at least there should be exact collection and reporting of data after the vaccines are given to this population! What a pity nobody seems to be doing that….
The ethical implications of the entire vaccine industry… Ethics… They don’t care about ethics or health. They only care about profit. Patient care and health is so far downstream of the decision making process, it’s not even on the administrators radar. Here we go again with yet another pointless study which side steps the basic question if we should be engaging in vaccination campaigns in the first place, if our natural immunity is superior from the start. I guess, throw more government tax dollars into studying if elderly should be part of the other studies. Endless studies. Forever. What irrelevant reason will they dream up for the next study ?
What they’re actually doing is maintaining the illusion of their own relevance and justification of continued employment, a little pr spin so we have to hear about vaccine something literally every single day of our lives, more endless studies. The kind that nobody needed and nobody asked for in the first place. Everyone gets to pay for this under involuntary servitude because it’s funded by taxpayers. You don’t get a vote. “Safe and effective. Safe and effective. Safe and effective. Protect grandma.” The parrot squaked. How do you think they got most of that cognitive impairment in the first place? It wasn’t their healthy diets.