Interventions to Improve Immunization Coverage among Children and Adolescents: A Meta-analysis

Faareha A. Siddiqui, Zahra A. Padhani, Rehana A. Salam, Razia Aliani, Zohra S. Lassi, Jai K. Das, Zulfiqar A. Bhutta

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16 Citations (Scopus)


BACKGROUND AND OBJECTIVES: Vaccinations are recognized as a feasible, cost-effective public health intervention for reducing the burden and associated mortality of many infectious diseases. The purpose of this study was to evaluate the effectiveness of potential interventions to improve the uptake of vaccines among children and adolescents. METHODS: We performed a literature search until December 2020. Eligible studies were identified using Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, and other sources. We included studies conducted on children and adolescents aged 5 to 19 years. Studies comprised of hospitalized children and those with comorbid conditions were excluded. Two authors independently performed the meta-analysis. RESULTS: Findings from120 studies (123 articles), of which 95 weremeta-analyzed, reveal that vaccination educationmay increase overall vaccination coverage by 19% (risk ratio [RR], 1.19; 95% confidence interval [CI], 1.12-1.26), reminders by 15% (RR, 1.15; 95% CI, 1.11-1.18), interventions for providers by 13% (RR, 1.13; 95% CI, 1.07-1.19), financial incentives by 67% (RR, 1.67; 95% CI, 1.40-1.99), andmultilevel interventions by 25% (RR, 1.25; 95% CI, 1.10-1.41). The impact of school-based clinics and policy and legislation on overall vaccination coverage is still uncertain, and no impact of amulticomponent intervention on overall vaccination coverage was found. CONCLUSIONS: Educational interventions, reminders, provider-directed interventions, financial incentives, and multilevel interventions may improve vaccination coverage among schoolaged children and adolescents.

Original languageEnglish
Article numbere2021053852D
Publication statusPublished - 1 May 2022


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