The immune system weakens naturally with age, leaving them increasingly susceptible
Each year, as the rains return to Costa Rica, so too does the quiet threat of influenza — a virus that reserves its cruelest consequences for the oldest and most fragile among us. The national health system, the CCSS, has administered nearly 400,000 flu vaccines in 2026, yet finds itself at only a quarter of its goal, with fewer than one in five elderly adults protected as the rainy season draws near. It is a familiar human paradox: the tools of prevention exist, access has been widened, and still the most vulnerable hesitate. The distance between a vaccine and an arm is sometimes not a matter of logistics, but of urgency not yet felt.
- Costa Rica's flu vaccination campaign has reached only 26% of its 2026 target by mid-May, with the rainy season — historically the peak of respiratory illness — fast approaching.
- The most alarming gap is among adults over 58, where just 18.9% have been vaccinated despite being the group most likely to be hospitalized or killed by influenza.
- Children under eight and pregnant women are also dangerously under-protected, with coverage rates of 9.7% and 25.5% respectively, leaving two of the campaign's priority groups exposed.
- The CCSS has expanded clinic hours into evenings and weekends and launched community outreach, offering free shots to all priority groups at any health facility — yet broader access has not yet moved the numbers.
- Health officials are now in a race against the calendar, warning that without a significant surge in uptake, the seasonal pressure on hospitals will arrive before the population is adequately shielded.
Nearly 400,000 Costa Ricans have received a flu vaccine so far in 2026, but the national health system is sounding an alarm: that figure represents only 26 percent of the CCSS's campaign goal, and the people most at risk are the ones least likely to have shown up.
The sharpest concern is among adults over 58. Only 120,868 people in this age group have been vaccinated — a coverage rate of just 18.9 percent. The CCSS's national immunization coordinator, Dr. Elvis Delgado Delgado, has been direct about what that means: aging immune systems are less equipped to withstand influenza's assault, and for older adults the virus is not merely an inconvenience — it hospitalizes and kills. Children between six months and eight years old sit at 9.7 percent coverage, while pregnant women, a designated priority group, have reached 25.5 percent.
The campaign itself is extensive. The CCSS purchased 1.5 million doses and is offering free vaccination to a wide range of groups — the elderly, pregnant women, young children, people with chronic conditions, health workers, teachers, and others. Clinics have extended into evenings and weekends, and outreach has reached communities across the country. Any eligible person can walk into any CCSS facility with identification and receive a shot.
Yet expanded access has not translated into the uptake officials need. The rainy season is approaching, and with it the annual surge in respiratory illness that strains hospitals and overwhelms clinics. The CCSS's message is urgent: the window to prevent severe complications is narrowing, and the vaccine remains the most effective tool available. The question is whether enough people — especially the elderly — will act before the season peaks.
Nearly 400,000 Costa Ricans have rolled up their sleeves for a flu shot so far this year, but the national health system is sounding an alarm: they're only a quarter of the way there, and the people who need protection most are staying away.
The Costa Rican Social Security Fund, known as CCSS, reported 395,401 vaccinations administered by mid-May, representing 26 percent progress toward its 2026 campaign goal. The numbers tell a story of uneven uptake across the population, with some groups responding well and others—particularly the elderly—lagging dangerously behind. As the rainy season approaches and respiratory viruses begin their seasonal climb, health officials are intensifying their push to get shots into arms before the pressure on hospitals becomes acute.
The most troubling gap is among adults over 58, the very population most vulnerable to severe flu complications. Only 120,868 people in this age group have been vaccinated, a coverage rate of just 18.9 percent. Dr. Elvis Delgado Delgado, the CCSS's national immunization coordinator, explained the stakes plainly: as people age, their immune systems naturally weaken, leaving them increasingly susceptible to the kind of respiratory damage influenza can inflict. The virus doesn't just cause discomfort in older adults—it hospitalizes them, and it kills them. Yet fewer than one in five have sought protection.
Children and pregnant women present another worry. Among children between six months and eight years old, only 39,414 have received the vaccine, yielding a coverage rate of 9.7 percent. Pregnant women, designated as a priority group by the National Vaccination and Epidemiology Commission, have reached 25.5 percent coverage with 8,752 doses administered. The CCSS has also vaccinated 206,564 people aged 8 to 57 with chronic conditions—diabetes, heart disease, obesity, chronic respiratory illness, cancer, and immune disorders among them—but even this group sits at just 5.6 percent coverage.
The campaign itself is broad. The CCSS is offering free vaccination to multiple risk groups: the elderly, pregnant women at any stage of pregnancy, children over six months, people with chronic diseases, health workers, firefighters, police, emergency responders, teachers, caregivers for the elderly, and workers in poultry and pig farming. The institution purchased 1.5 million doses for the year and has expanded access through evening hours, weekend clinics, and outreach efforts in communities across the country. Anyone in a priority group can walk into any CCSS health facility with their identification and receive a shot, regardless of where they live.
But expanded access hasn't translated into uptake. The CCSS is now racing against the calendar. The rainy season historically brings a surge in respiratory illness, a period when hospitals fill and clinics overflow. Without higher vaccination rates—especially among the elderly and other vulnerable populations—that seasonal pressure will hit harder. The institution's message is clear: the window to prevent severe illness is closing. The vaccine remains one of the most effective tools available to stop the virus from causing serious complications, hospitalization, and death. The question now is whether enough people will heed the call before the season peaks.
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As people age, their immune systems naturally weaken, leaving them increasingly susceptible to respiratory damage from influenza— Dr. Elvis Delgado Delgado, CCSS national immunization coordinator
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Why is the elderly population so resistant to getting vaccinated when they're the ones most at risk?
That's the question keeping health officials up at night. The source doesn't tell us the reason—whether it's distrust, inconvenience, lack of awareness, or something else. We only know the gap exists and it's dangerous.
What does 26 percent coverage actually mean in practical terms?
It means roughly three-quarters of the target population still hasn't been vaccinated. The CCSS bought 1.5 million doses, so they're on pace to use maybe 390,000 by the time the rainy season really hits. That's a lot of unprotected people heading into the season when respiratory viruses spread fastest.
The numbers for children are even worse than for the elderly—9.7 percent. Why is that?
Children require a parent or guardian to bring them in. That adds a layer of friction that doesn't exist for adults making their own decisions. And pregnant women at 25.5 percent—that's a group the health system specifically prioritized, yet still three-quarters haven't come.
Has the CCSS actually made it easy to get vaccinated?
By the account here, yes. Evening hours, weekend clinics, community outreach, no requirement to go to your local clinic. You can show up anywhere with an ID. The barriers are low. So the resistance seems to be something else—hesitation, complacency, or simply not seeing the urgency.
What happens if they don't hit higher coverage before the rains come?
The hospitals get overwhelmed. The elderly end up hospitalized or worse. The system strains. It's not hypothetical—this is what happens every year. The vaccine is meant to prevent that. Without it, you're gambling with vulnerable lives.