Background – India is considered as the vaccine manufacturing hub of the world and launched a mega vaccine drive for Covid-19, nevertheless it has encountered vaccine hesitancy. Objectives -This study was done, with the objective to find out the Covid-19 vaccination coverage and its determinants among the elderly in a rural area of Kerala as well to find out any change in Covid appropriate behaviour among the vaccinees and various AEFI occurrences in this group. Methods – We have done a cross sectional study in a rural area of Kerala with a sample of 684 persons selected by cluster sampling in October 2021 and the data collection tool adopted was interview schedule with a pretested questionnaire. Results – The prevalence of Covid vaccination coverage were 95.3% (95% CI 93.7-96.9). The associated factors were age(p=0.013), education status of the vaccines (p=0.01) and education of spouse (0.001). The predictors found on regression analysis were, old age (adjusted odds ratio with 95%CI .260 (0.09-0.74) and low education level of spouse (adjusted odds ratio with 95%CI 3.613 (1.367-9.551). The statistical difference between the adverse effects after the first dose (46.9%) and second dose (32.5%) of covid vaccination was significant (p value from Mc-Nemar test =0.000) and no statistically significant change was found in Covid appropriate behaviour (p=0.5). Conclusion – India is a country where vaccination drive was ramped up in a phased manner as soon as possible with increased availability of the vaccines and this study shows the rural population itself had a big coverage and covid vaccination programme is poised for success.