International Journal of Clinical Case Reports, 2025, Vol.15, No.5, 228-238 http://medscipublisher.com/index.php/ijccr 232 there are usually no more than five cases (Patone et al., 2021). Most severe reactions occur in the first week after vaccination and are related to certain types of vaccines, such as viral vector vaccines. In addition, mRNA vaccines may also lead to rare cases of myocarditis, especially in young people (Li et al., 2022; Xu et al., 2023) Figure 2 Frequencies and grades of adverse reactions after each dose of the vaccine (Adopted from Xu et al., 2023) The underlying causes of serious adverse events may be related to age-related changes in vascular function, immune response and coagulation process, which may make the elderly more prone to excessive inflammatory response or thrombosis. However, the risk of serious consequences brought by COVID-19 infection itself is much higher than that of vaccination, and the protective effect of vaccination in preventing severe illness and death is very significant (Montano, 2022). 4.3 Risk factors specific to the elderly There are several factors specific to the elderly that can affect the risk and specific circumstances of adverse events after COVID-19 vaccination. Advanced age, multiple chronic diseases (such as hypertension, diabetes, cardiovascular diseases), and physical weakness can increase the probability of mild and severe adverse reactions (Xu et al., 2023). In addition, with age, changes in the immune system and vascular system may make the elderly more prone to certain adverse events, such as thrombosis or cardiovascular complications (Montano, 2022; Al-Shargi et al., 2023). Despite the risks, studies have shown that the COVID-19 vaccine is generally safe for the elderly, and the probability of reaction is similar to or only slightly higher than that of young people (Wang et al., 2022). Timely, open and clear notification of adverse reactions and continuous monitoring are of great significance for maintaining public confidence and helping the elderly and their medical staff truly understand the pros and cons of vaccination (Li et al., 2022). 5 Nursing Observation and Intervention Strategies During COVID-19 Vaccination 5.1 Assessment and preparation before vaccination Before getting vaccinated, the elderly should undergo a comprehensive health assessment, especially those with underlying diseases such as hypertension and chronic kidney disease. Nurses need to know their past medical history, daily medication use, the number of chronic diseases they have, and whether they have ever been allergic to vaccines or their components in the past. In particular, it is necessary to clearly define under which health conditions vaccination is not appropriate. For groups with more complex health conditions such as dialysis patients and elderly people with cardiovascular diseases, corresponding medical examinations should be completed before vaccination (Afshar et al., 2021). Such evaluations can help avoid risks and enable individuals to arrange vaccination reasonably based on their actual conditions. The preparatory work also includes clearly explaining to patients and their families the benefits and possible risks of getting vaccinated against COVID-19. Nurses play a crucial role in helping the elderly reduce their concerns, correct misinformation, and ensure that they voluntarily get vaccinated after understanding the situation. Clearly explaining the vaccination process, possible adverse reactions and the importance of completing all doses can enhance the trust of the elderly in vaccines and encourage more people to get vaccinated (Burden et al., 2021; Xu et al., 2023).
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