Enhancing Vaccination Uptake for Healthy Aging Through Context-Aware Mhealth Systems: A Systematic Literature Review for Future Smart Healthcare

Vaccination significantly contributes to healthy aging; however, older adults frequently face cognitive, accessibility, and communication barriers that result in suboptimal vaccine uptake. This systematic literature review identifies key determinants of vaccine hesitancy and evaluates technological strategies to improve immunization rates among older adults. We conducted a structured search of the PubMed database for studies published between 2020 and 2025, with the final search completed on 20 December 2025. Using a custom 1–3 relevance and quality scoring framework, findings from 27 eligible studies were synthesized. Our analysis reveals a complex landscape of cognitive, accessibility, and language-related barriers, alongside promising interventions such as personalized messaging, targeted letters, and automated reminders. Evidence demonstrates that tailored communication delivered via user-centered mHealth applications can effectively reduce vaccine hesitancy and improve uptake. Personalized outreach aligned with individual health profiles, communication preferences, and timing emerges as a key enabler of sustained engagement. Building on these insights, this review examines how context-aware mHealth systems can be designed to promote vaccination among diverse aging populations. We propose GoldenVaxShield, a context-aware, AI-powered mHealth solution that leverages personalized messaging, reminders, and real-time feedback to support informed decision-making and timely vaccination. By integrating advanced technologies with personalization and accessibility principles, GoldenVaxShield aims to enhance preventive healthcare engagement, improve vaccination coverage, and support healthy aging. While variability in study methodologies and a focus on technology-driven interventions remain considerations, the findings highlight the potential of personalized digital outreach as a scalable pathway to improving population-level vaccine uptake.