Older Adults’ Lack of Online Medical Accounts Could Affect COVID-19 Vaccinations


In addition to communicating about COVID-19 vaccine eligibility, uses for online portals include requesting prescription refills, seeking advice on health concerns, and scheduling appointments.

New poll data have found that 45% of adults over 65 years of age do not have an account with their health provider’s online portal system, through which it could be easier for physicians to communicate with them about available coronavirus disease 2019 (COVID-19) vaccines and for them to schedule appointments.

Online patient portals are secure systems linked to a health care provider’s electronic medical record system. Patients can access them using a computer or smartphone, and they can communicate with health providers, schedule appointments, or view some test results.

According to a press release, the poll found that 45% of adults aged 65 to 80 years and 42% of adults aged 50 to 80 years have not set up an online account. Although still a high proportion, the new data actually represents an improvement. A poll taken in March 2018 found that 49% of adults in the same age range had not set up patient portal access.

“Right now, one important thing that we can do for older adults is encourage and help them to sign up for patient portal access or log in again if they haven’t in a while, if their provider offers one, and especially if it will be used as part of the COVID-19 vaccination process,” said Preeti Malani, MD, director of the poll, in a press release. “If they don’t have a computer, or they need help navigating the technology, they can appoint a trusted adult as their ‘proxy’ to access their account.”

The analysis showed significantly lower utilization of patient portals among adults who have the highest risk of a severe case of COVID-19, whether because of age or race. Just under 50% of Black older adults and 53% of Hispanic older adults lacked an account by June 2020, compared with 39% of white older adults. Men were also less likely than women to have accounts, although that gap has narrowed since 2018.

The biggest gap was found between adults with annual household incomes less than $60,000 per year and those with higher incomes. Approximately 54% of the lower-income older adults did not have a patient portal account, whereas just 35% of higher-income older adults lacked an account. Furthermore, 53% of those with less than a high school education lacked a patient portal account, compared with 31% of those who had graduated from college.

The analysts noted that these systems are becoming increasingly important as patients become eligible for COVID-19 vaccines. In a press release, Malani said Michigan Medicine has begun notifying patients over 65 years of age who have an online portal account that they will receive notifications through the portal when it is their turn to schedule an appointment. Patients without accounts will receive mailed letters inviting them to schedule appointments by phone.

“Vaccination is so critical to protect their health, and we don’t want technology to stand in their way,” Malani said in a press release.

In the 2018 poll, respondents cited a lack of awareness, lack of need, lack of comfort with the technology, and dislike of communicating about their health online as reasons for not setting up a patient portal. Even at that time, however, just 26% said their health care provider did not offer a patient portal.

The authors said that as more physicians become affiliated with large health systems that have started offering a central portal system, it is likely that older adults will have more access than before. Managing COVID-19 vaccines is just one benefit of the portals as well, as adults with accounts cited various other reasons for using the service.

Among those who had set up a patient portal account before the 2018 poll, the most common use was to view test results (84%). Other uses included requesting a prescription refill (43%), scheduling an appointment (37%), requesting reminders about upcoming appointments (34%), getting advice about a health concern (26%), updating insurance or contact information (22%), and requesting a referral (13%).


45% of Adults Over 65 Lack Online Medical Accounts, Which Could Affect COVID-19 Vaccination [news release]. University of Michigan Health; January 15, 2021. https://labblog.uofmhealth.org/health-tech/45-of-adults-over-65-lack-online-medical-accounts-which-could-affect-covid-19. Accessed January 19, 2021.

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