Affiliation:
1. Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
2. Robinson Research Institute, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia;
3. Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Canada
Abstract
BACKGROUND AND OBJECTIVES
Vaccinations are recognized as a feasible, cost-effective public health intervention for reducing the burden and associated mortality of many infectious diseases. The purpose of this study was to evaluate the effectiveness of potential interventions to improve the uptake of vaccines among children and adolescents.
METHODS
We performed a literature search until December 2020. Eligible studies were identified using Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, and other sources. We included studies conducted on children and adolescents aged 5 to 19 years. Studies comprised of hospitalized children and those with comorbid conditions were excluded. Two authors independently performed the meta-analysis.
RESULTS
Findings from 120 studies (123 articles), of which 95 were meta-analyzed, reveal that vaccination education may increase overall vaccination coverage by 19% (risk ratio [RR], 1.19; 95% confidence interval [CI], 1.12–1.26), reminders by 15% (RR, 1.15; 95% CI, 1.11–1.18), interventions for providers by 13% (RR, 1.13; 95% CI, 1.07–1.19), financial incentives by 67% (RR, 1.67; 95% CI, 1.40–1.99), and multilevel interventions by 25% (RR, 1.25; 95% CI, 1.10–1.41). The impact of school-based clinics and policy and legislation on overall vaccination coverage is still uncertain, and no impact of a multicomponent intervention on overall vaccination coverage was found.
CONCLUSIONS
Educational interventions, reminders, provider-directed interventions, financial incentives, and multilevel interventions may improve vaccination coverage among school-aged children and adolescents.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology and Child Health
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