Despite the availability of safe and effective vaccines, older adults and frail people (OAFs) remain far from accomplishing the recommended coverage targets. The SARS-CoV-2 pandemics strongly affected the supply and coverage of routine vaccines, especially for OAFs, but it also suggested innovative solutions to catch up with the immunization schedules we were late with. Italia Longeva, the National Association for Active Longevity established in 2011 by the Ministry of Health, realized this research aiming to collect and share local good practices for the routine immunization of OAFs implemented during the SARS-CoV-2 pandemic. We surveyed 12 local health directors from 9 Regions (with a potential covered area of about 24 million inhabitants) between January and March 2021. Starting from the 2018 Thomas and Lorenzetti’s Cochrane Review, a “snowball” search of scientific and grey literature was performed to create and validate a 27-items semi-structured questionnaire used to collect information during the interviews. Full methods are available online (https://www.italialongeva.it/). A wide range of organizational models and settings for immunization supply to OAFs were found across regions. The local implementation of the 27 interventions to increase vaccination coverage among OAFs identified through the literature review ranges from 0% to 100%, with higher rates for interventions targeting the professionals (i.e. audits), lower when aimed to increase the vaccine offer (i.e. active calls) or its accessibility (i.e. home vaccination). Seven good local practices have been identified and described: Mass Vaccination Centre; drive-through Vaccination; Mobile vaccination clinics; co-administration; collaboration within different organization; Electronic immunization registries; standardized immunization pathways. Literature suggests many effective interventions to improve immunization of OAFs, but their implementation at local level shows huge heterogeneity. Providers should combine several interventions adequate to the specific context (organizational models, interoperability, urban or rural context, etc) and share good practices.