Vaccination is the primary defence against SARS-CoV-2, especially among the elderly and those with chronic conditions. Using a nationally representative sample of 12,900 participants from the fifth wave (2021-22) of the China Health and Retirement Longitudinal Study (CHARLS), we examined the COVID-19 vaccination status and the determinants of vaccination hesitancy in Chinese adults 52 and older. By July-August of 2022, 92.3% of the Chinese population 60 years and older had received at least one COVID-19 vaccination, 88.6% completed the primary series, and 72.4% received a booster. Those aged 80 years and older had lower vaccination rates, with 71.9% and 46.7% completed the primary series and booster shots, respectively. These statistics represented the situation before China ended the Zero-Covid policy in November 2022 because vaccination stagnated between July-August and November. Multivariate regressions revealed that oldest age groups (70 and older, especially 80 and older), female, unmarried, urban residents, functionally dependent, and with chronic conditions were less likely to receive COVID-19 vaccines. Our regression results were corroborated by self-reported reasons for non-vaccination. Vaccination hesitancy has likely contributed to excessive mortality among the vulnerable populations after China ceased its zero-COVID practice. Our study provides important lessons on how to balance containment efforts with vaccination and treatment measures, and on the need to clarify vaccine’s side effects and contraindications early on.