Do peer-based education interventions effectively improve vaccination acceptance? a systematic review

Abstract

Background Vaccination efforts are a vital part of controlling the spread of diseases, however, lack of vaccine acceptance undermines the efficacy of this public health effort. Current evidence suggests that the most effective interventions to support vaccination uptake and positive vaccination beliefs are multicomponent, and dialogue based. Peer-based education interventions are such a strategy that involves an individual within the same group to act as the vaccine educator. Objective This review aims to consolidate the quantitative evidence surrounding the effectiveness and experience of peer-based education initiatives to improve vaccination beliefs and behaviors. Methods We conducted a systematic search of PubMed, Web of Science, and a hand reference search. The search was conducted between April and June 2022. The inclusion criteria encompassed using peers, being education based, and being an intervention that addresses vaccination beliefs and behaviors (e.g. vaccination uptake). Results Systematic screening revealed 16 articles in the final review. Half of the studies focused on students as their study population. The human papillomavirus vaccine was the most common vaccine assessed in the studies, followed by COVID and influenza vaccines. 11 out of 16 of the articles reported a positive impact of the peer intervention and two studies had mixed results. Six studies suggest a mixed peer- healthcare expert approach. Conclusions Despite reported positive effects of using peer-education based initiatives to improve vaccine uptake and beliefs, this systematic review reveals that there is limited existing research in support of this strategy. The strategies that initially appear the most effect are those with a combined peer and health-expert approach, and those that have more group specific and long-term peer interventions. More research is needed to confirm these results and to assess the effectiveness of a peer-based education intervention in a wider variety of settings and for other vaccine types.

Vaccine confidence mediates the association between a pro-social pay-it-forward intervention and improved influenza vaccine uptake in China: A mediation analysis

“…The parallel mediation analysis results showed that, amongst the three vaccine confidence domains, vaccine importance was identified as the only significant mediator of the association between the pay-it-forward intervention and vaccine uptake, and confidence in safety and effectiveness were found to be less relevant to the mediation pathway in our study sample. Our interpretation is that, in the Chinese market where there is still limited awareness and demand for influenza vaccines, pay-it-forward approach as an intervention package containing educational, peer-based psycho-behavioral, and community engagement components may help enhance public awareness and trust, perceived vaccine importance and subsequent acceptance of the vaccine [36] , [37] , [38] . This is supported by previous pay-it-forward studies suggesting that positive experiences (e.g., kindness and reciprocity generated among the community through donations and handwritten messages) contributed to community solidarity, public trust and encouraged people to receive medical service [39] , [40] , [41] , [42] , [43] .…”

Patterns of basic pneumococcal conjugated vaccine coverage in Ethiopia from 2015 to 2018; further analysis of Ethiopian DHS (2016–2019)

“…Educated mothers have greater access to healthcare services, sources of information that support vaccination, and knowledge of the advantages and risks of vaccine-preventable diseases. They may also be influenced by peer-based education interventions that use conversation and trust to encourage vaccination [50] , [51] .…”

Interventions to increase vaccination in vulnerable groups: rapid overview of reviews

“…A large number of reviews published or indexed after December 2022 evaluated vaccination uptake and barriers and facilitators to this in both general populations and minority or otherwise vulnerable groups in the context of COVID-19 vaccination programmes. However, only three reviews would have been eligible for inclusion in out review [ 38 – 40 ].…”

“…One contained a single relevant RCT relating to willingness to receive COVID-19 vaccination among black and minority ethnic people in the UK and explored the effectiveness of exposure to different forms of written information [ 40 ]. Another contained two relevant RCTs targeting influenza vaccination in older adults with or without additional markers of vulnerability or marginalisation [ 38 ]. While we would include these reviews in an update of this overview we do not consider that they are likely to substantively change our findings.…”