New Cochrane review highlights ineffectiveness of adolescent vaccine uptake strategies

  • Abdullahi LH & al.
  • Cochrane Database Syst Rev
  • 17 Jan 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • A variety of strategies (vaccine education, mandatory vaccination laws, multifaceted) are tied to general improvement in vaccination uptake among adolescents but may not be applicable to lower/middle-income countries.
  • Overall evidence is low to moderate.

Why this matters

  • Provide multicomponent education on vaccine effectiveness, schedules, and benefits to caregivers and adolescent patients.

Key results

  • 16 studies (12 US, 1 Australia, 1 Sweden, 1 Tanzania, 1 UK).
  • Health education vs usual practice:
    • Improved HPV vaccination uptake: risk ratio (RR), 1.43 (95% CI, 1.16-1.76; 3 randomized controlled trials [RCTs]; 1054 participants; high evidence).
  • Complex vs simplified health education:
    • Multicomponent education: little/no effect on HepB vaccine uptake (full schedule) vs information leaflets: RR, 0.98 (95% CI, 0.97-0.99; 1 RCT; n=17,411; moderate evidence).
  • Financial incentives:
    • May improve HPV vaccine uptake: 1 dose, RR=1.45 (95% CI, 1.05-1.99; 1 RCT; n=500; low evidence).
  • Health education plus financial incentives:
    • Completed HepB vaccine uptake: RR, 1.38 (95% CI, 0.96-2.00; 1 RCT; n=104; very low evidence).
  • Mandatory vaccination:
    • Probable HepB uptake: RR, 3.92 (95% CI, 3.65-4.20; 1 non-RCT; n=6462; moderate evidence).

Study design

  • Cochrane review evaluating strategies to improve adolescent vaccine uptake, ages 10-19 years.
    • Primary outcome: adolescent vaccination coverage.
  • Funding: Department for International Development, UK.

Limitations

  • Limited generalizability.
  • Small effect sizes.