COVID-19 Hospitalizations Among Adults 65 and Older, January–August 2023

This page describes a CDC report on 2023 data and the vaccine recommendations of that time.

Since March 2020, adults aged 65 and older have had the highest COVID-19 hospitalization rates of any age group, rising with age. CDC's COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) — covering 98 counties in 13 states, about 10% of the U.S. population — looked at hospitalizations in this group during 2023.

Hospitalization rates

• From January 1 to July 8, 2023, the weekly rate among adults 65 and older fell 86%, from 42.2 to 5.9 per 100,000 — the lowest since July 2021.
• It then rose to 6.8 in the week ending July 15 and to 16.4 by the week ending August 26 — more than double.
• That week, the rate for adults 65 and older was 9 times that for adults 18–64 (1.8) and 16 times that for people under 18 (1.0). Among older adults it was highest at 85 and older (42.2) and lowest at 65–74 (8.6).

Weekly COVID-19-associated hospitalization rates by age group, 2023. CDC figure.

Older adults' share

Adults 65 and older accounted for 62.9% of all COVID-19 hospitalizations from January to August 2023, up by a third from 45.9% during March 2020–December 2022. In a sample of hospitalizations from January to June 2023, they accounted for 61.3% of intensive care admissions and 87.9% of in-hospital deaths.

Who was hospitalized

From a sample of 1,465 of the 21,445 hospitalizations among adults 65 and older (January–June 2023), 1,133 (79.5%) were likely admitted because of COVID-19 illness. Among them:

• 31.0% were 65–74, 36.5% were 75–84 and 32.5% were 85 or older;
• 202 (17.7%) lived in long-term care facilities;
• 176 (14.4%) went to intensive care, 68 (5.9%) needed invasive mechanical ventilation and 63 (4.8%) died in hospital.

Severe outcomes among hospitalized adults 65 and older, January–June 2023. CDC figure.

Underlying conditions: 98.5% had at least one and 90.3% had two or more — most often diabetes (39.0%), kidney disorders (28.0%), coronary artery disease (27.4%), chronic heart failure or cardiomyopathy (26.1%) and obesity (25.6%). An earlier COVID-NET analysis found that having two or more conditions more than quadrupled the risk of hospitalization, after accounting for age, sex, and race and ethnicity.

Vaccination: 15.9% had never been vaccinated against COVID-19, 58.6% had received only the original monovalent vaccine, and just 23.5% had received at least one bivalent dose.

What CDC advised

The Advisory Committee on Immunization Practices had recommended a bivalent dose in September 2022, and at least one more for adults 65 and older in April 2023; it then recommended the updated 2023–2024 COVID-19 vaccine for everyone 6 months and older. Although bivalent vaccine protection against hospitalization wanes over time, it has been shown to prevent hospitalization and severe outcomes such as intensive care.

To reduce their risk, adults at higher risk, including everyone 65 and older, should:

• get recommended COVID-19 vaccines;
• take steps to avoid infection;
• seek prompt outpatient antiviral treatment after testing positive — ritonavir-boosted nirmatrelvir (Paxlovid), remdesivir (Veklury) or molnupiravir (Lagevrio).

Limitations: some hospitalizations may have been missed because of testing practices, so rates may be underestimated; whether COVID-19 was the reason for admission could be misclassified; and COVID-NET covers about 10% of the population, so results may not apply nationwide.

Sources

• Taylor CA, Patel K, Patton ME, et al. "COVID-19–Associated Hospitalizations Among U.S. Adults Aged ≥65 Years — COVID-NET, 13 States, January–August 2023." Morbidity and Mortality Weekly Report 72(40), Centers for Disease Control and Prevention (corrected report).
• The report is inconsistent in places: it gives the older adults' share of sampled hospitalizations as 62.8% in its results but 62.9% in its summary, and its discussion describes their share of hospitalizations and intensive care admissions as about one half. This page uses the figures from its results.