- 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.
- 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).
- Cochrane review evaluating strategies to improve adolescent vaccine uptake, ages 10-19 years.
- Primary outcome: adolescent vaccination coverage.
- Funding: Department for International Development, UK.
- Limited generalizability.
- Small effect sizes.