Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
Institut National de Santé Publique du Québec, Québec City, QC, Canada; Faculty of Medicine, Department of Social and Preventive Medicine, Québec City, QC, Canada; Centre de recherche du CHU de Québec, Québec City, QC, Canada.
Vaccine. 2023 Aug 14;41(36):5233-5244. doi: 10.1016/j.vaccine.2023.07.036. Epub 2023 Jul 26.
Hospital settings represent an opportunity to offer and/or promote childhood vaccination. The purpose of the systematic review was to assess the effectiveness of different hospital-based strategies for improving childhood vaccination coverage.
A systematic search of multiple bibliographic databases, thesis databases, and relevant websites was conducted to identify peer-reviewed articles published up to September 20, 2021. Articles were included if they evaluated the impact of a hospital (inpatient or emergency department)-based intervention on childhood vaccination coverage, were published in English or French, and were conducted in high-income countries. High quality studies were included in a narrative synthesis.
We included 25 high quality studies out of 7,845 unique citations. Studies focused on routine, outbreak, and influenza vaccines, and interventions included opportunistic vaccination (i.e. vaccination during hospital visit) (n = 7), patient education (n = 2), community connection (n = 2), patient reminders (n = 2), and opportunistic vaccination combined with patient education and/or reminders (n = 12). Opportunistic vaccination interventions were generally successful at improving vaccine coverage, though results ranged from no impact to vaccinating 71 % of eligible children with routine vaccines and 9-61 % of eligible children with influenza vaccines. Interventions that aimed to increase vaccination after hospital discharge (community connection, patient education, reminders) were less successful.
Some interventions that provide vaccination to children accessing hospitals improved vaccine coverage; however, the baseline coverage level of the population, as well as implementation strategies used impact success. There is limited evidence that interventions promoting vaccination after hospital discharge are more successful if they are tailored to the individual.
医院环境提供了提供和/或推广儿童疫苗接种的机会。本系统评价的目的是评估不同基于医院的策略对提高儿童疫苗接种覆盖率的有效性。
系统地搜索了多个书目数据库、论文数据库和相关网站，以确定截至 2021 年 9 月 20 日发表的同行评审文章。如果文章评估了基于医院（住院或急诊部）的干预对儿童疫苗接种覆盖率的影响、发表在英语或法语中、并在高收入国家进行，则将其纳入。高质量的研究被纳入叙述性综合。
我们从 7845 条独特的引文中共纳入了 25 项高质量的研究。这些研究侧重于常规、暴发和流感疫苗，干预措施包括机会性疫苗接种（即在医院就诊期间接种疫苗）（n=7）、患者教育（n=2）、社区联系（n=2）、患者提醒（n=2）以及机会性疫苗接种结合患者教育和/或提醒（n=12）。机会性疫苗接种干预措施通常能够提高疫苗接种率，尽管结果从没有影响到常规疫苗接种 71%的合格儿童和流感疫苗接种 9-61%的合格儿童不等。旨在增加出院后接种疫苗的干预措施（社区联系、患者教育、提醒）效果较差。
一些为接受医院治疗的儿童提供疫苗接种的干预措施提高了疫苗接种率；然而，人群的基线接种率以及所使用的实施策略会影响效果。有有限的证据表明，如果针对个人量身定制，出院后促进疫苗接种的干预措施如果更成功。
