He heard evidence at an online hearing in the Court of Protection, where judges consider issues relating to people who lack the mental capacity to make decisions, on Friday, and was told that much of the woman’s cognitive function had gone.
A lawyer appointed to represent the woman, who never married and had no children, had asked him to make a decision about vaccination.
Hayden, who heard evidence from health staff and a care home manager, said the woman could not be identified in media reports.
Social services bosses at the London Borough of Richmond have welfare responsibilities for her.
The judge said evidence showed that she had a long-standing opposition to vaccines and would need to be restrained or sedated before being given an injection.
He said he was not attracted to either option.
“She would resist, I have no doubt, any restraint and it would create a traumatic and disturbing scenario, for her, for her carers, and for the other residents,” said Hayden, in a ruling.
“Although much of her cognitive function may have gone, her autonomy, and her own sense of it, continues.”
The judge, who is based in London and also oversees hearings in the Family Division of the High Court, added: “Ultimately, in my judgment, it is that which requires to be respected and is, ultimately, determinative.”