Granade Charleigh J, Lindley Megan C, Jatlaoui Tara, Asif Amimah F, Jones-Jack Nkenge
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Oak Ridge Institute for Science and Education, U.S. Department of Energy, Atlanta, Georgia, USA.
Health Equity. 2022 Mar 7;6(1):206-223. doi: 10.1089/heq.2021.0177. eCollection 2022.
Adult vaccination coverage remains low in the United States, particularly among racial and ethnic minority populations.
To conduct a comprehensive literature review of research studies assessing racial and ethnic disparities in adult vaccination.
We conducted a search of PubMed, Cochrane Library, ClinicalTrials.gov, and reference lists of relevant articles.
Research studies were eligible for inclusion if they met the following criteria: (1) study based in the United States, (2) evaluated receipt of routine immunizations in adult populations, (3) used within-study comparison of race/ethnic groups, and (4) eligible for at least one author-defined PICO (patient, intervention, comparison, and outcome) question.
Preliminary abstract review was conducted by two authors. Following complete abstraction of articles using a standardized template, abstraction notes and determinations were reviewed by all authors; disagreements regarding article inclusion/exclusion were resolved by majority rule. The Social Ecological Model framework was used to complete a narrative review of observational studies to summarize factors associated with disparities; a systematic review was used to evaluate eligible intervention studies.
Ninety-five studies were included in the final analysis and summarized qualitatively within two main topic areas: (1) factors associated with documented racial-ethnic disparities in adult vaccination and (2) interventions aimed to reduce disparities or to improve vaccination coverage among racial-ethnic minority groups. Of the 12 included intervention studies, only 3 studies provided direct evidence and were of Level II, fair quality; the remaining 9 studies met the criteria for indirect evidence (Level I or II, fair or poor quality).
A considerable amount of observational research evaluating factors associated with racial and ethnic disparities in adult vaccination is available. However, intervention studies aimed at reducing these disparities are limited, are of poor quality, and insufficiently address known reasons for low vaccination uptake among racial and ethnic minority adults.
美国成人疫苗接种覆盖率仍然较低，尤其是在种族和少数民族人群中。
对评估成人疫苗接种中种族和民族差异的研究进行全面的文献综述。
我们检索了PubMed、Cochrane图书馆、ClinicalTrials.gov以及相关文章的参考文献列表。
符合以下标准的研究有资格纳入：（1）基于美国的研究；（2）评估成人常规免疫接种的接受情况；（3）在研究中对种族/民族群体进行组内比较；（4）符合至少一个作者定义的PICO（患者、干预措施、对照和结局）问题。
由两位作者进行初步摘要审查。使用标准化模板对文章进行完整摘要后，所有作者对摘要笔记和判定结果进行审查；关于文章纳入/排除的分歧通过多数决解决。社会生态模型框架用于对观察性研究进行叙述性综述，以总结与差异相关的因素；系统综述用于评估符合条件的干预性研究。
95项研究纳入最终分析，并在两个主要主题领域进行定性总结：（1）与成人疫苗接种中记录的种族-民族差异相关的因素；（2）旨在减少差异或提高种族-民族少数群体疫苗接种覆盖率的干预措施。在纳入的12项干预性研究中，只有3项研究提供了直接证据，质量为II级，中等质量；其余9项研究符合间接证据标准（I级或II级，中等或低质量）。
有大量观察性研究评估了与成人疫苗接种中种族和民族差异相关的因素。然而，旨在减少这些差异的干预性研究有限，质量较差，且未充分解决种族和少数民族成年人疫苗接种率低的已知原因。
