Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy.
School of Medicine, University Kore of Enna, Enna, Italy.
JMIR Public Health Surveill. 2024 Jul 23;10:e52926. doi: 10.2196/52926.
To address the global challenge of vaccine hesitancy, the Strategic Advisory Group of Experts on Immunization strongly promotes vaccination reminder and recall interventions. Coupled with the new opportunities presented by scientific advancements, these measures are crucial for successfully immunizing target population groups.
This systematic review and meta-analysis aims to assess the effectiveness of various interventions in increasing vaccination coverage compared with standard or usual care. The review will cover all vaccinations recommended for different age groups.
In February 2022, 2 databases were consulted, retrieving 1850 studies. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 79 manuscripts were included after the assessment phase. These comprised 46 trials/randomized controlled trials (RCTs) and 33 before-after studies. A meta-analysis using a random-effects model was performed with STATA software (version 14.1.2). The selected outcome was the risk ratio (RR) of vaccination coverage improvement effectiveness. Additionally, meta-regression analyses were conducted for the included manuscripts.
The analyses showed an overall efficacy of RR 1.22 (95% CI 1.19-1.26) for RCTs and RR 1.70 (95% CI 1.54-1.87) for before-after studies when considering all interventions cumulatively. Subgroup analyses identified multicomponent interventions (RR 1.58, 95% CI 1.36-1.85) and recall clinical interventions (RR 1.24, 95% CI 1.17-1.32) as the most effective in increasing vaccination coverage for RCTs. By contrast, educational interventions (RR 2.13, 95% CI 1.60-2.83) and multicomponent interventions (RR 1.61, 95% CI 1.43-1.82) achieved the highest increases for before-after studies. Meta-regression analyses indicated that the middle-aged adult population was associated with a higher increase in vaccination coverage (RCT: coefficient 0.54, 95% CI 0.12-0.95; before-after: coefficient 1.27, 95% CI 0.70-1.84).
Community, family, and health care-based multidimensional interventions, as well as education-based catch-up strategies, effectively improve vaccination coverage. Therefore, their systematic implementation is highly relevant for targeting undervaccinated population groups. This approach aligns with national vaccination schedules and aims to eliminate or eradicate vaccine-preventable diseases.
为应对全球疫苗犹豫挑战，免疫战略咨询专家组（SAGE）大力提倡接种提醒和预约干预措施。结合科学进步带来的新机遇，这些措施对于成功为目标人群接种疫苗至关重要。
本系统评价和荟萃分析旨在评估与标准或常规护理相比，各种干预措施在提高疫苗接种率方面的效果。本综述将涵盖所有建议用于不同年龄组的疫苗接种。
2022 年 2 月，检索了 2 个数据库，共检索到 1850 项研究。根据 PRISMA（系统评价和荟萃分析的首选报告项目）指南，经过评估阶段，共纳入 79 篇文献。其中包括 46 项试验/随机对照试验（RCT）和 33 项前后对照研究。使用 STATA 软件（版本 14.1.2）进行了随机效应模型的荟萃分析。选择的结局是疫苗接种覆盖率改善效果的风险比（RR）。此外，对纳入的文献进行了荟萃回归分析。
分析结果显示，当综合考虑所有干预措施时，RCT 的总体效果为 RR 1.22（95%CI 1.19-1.26），前后对照研究的 RR 为 1.70（95%CI 1.54-1.87）。亚组分析发现，多组分干预（RR 1.58，95%CI 1.36-1.85）和召回临床干预（RR 1.24，95%CI 1.17-1.32）是 RCT 中提高疫苗接种覆盖率最有效的干预措施。相比之下，教育干预（RR 2.13，95%CI 1.60-2.83）和多组分干预（RR 1.61，95%CI 1.43-1.82）在前后对照研究中实现了最高的疫苗接种覆盖率增加。荟萃回归分析表明，中年成年人的疫苗接种覆盖率增加幅度更高（RCT：系数 0.54，95%CI 0.12-0.95；前后对照：系数 1.27，95%CI 0.70-1.84）。
以社区、家庭和医疗为基础的多维干预措施，以及基于教育的追赶策略，有效提高了疫苗接种率。因此，系统实施这些措施对于针对未充分接种疫苗的人群至关重要。这种方法与国家免疫计划相契合，旨在消除或根除疫苗可预防的疾病。
