We studied COVID-19 hospitalisation rates in elderly Maltese residents, aged 80 years and older, after national attainment of 70% first-dose coverage of COVID-19 vaccine in this age cohort. The milestone resulted in almost 50% reduction of hospital admissions, as confirmed by time series modelling using national SARS-CoV-2 infection rates as the comparator. The reduction was not seen in younger, as yet unvaccinated, age groups, where hospital admissions actually increased during the same period following a third wave of infections.