Strategies for addressing vaccine hesitancy – A systematic review

Abstract

Across the literature, few strategies to address vaccine hesitancy were found to have been evaluated for impact on either vaccination uptake and/or changes in knowledge, awareness or attitude (only 14% of peer reviewed and 25% of grey literature). The majority of evaluation studies were based in the Americas and primarily focused on influenza, human papillomavirus (HPV) and childhood vaccines. In low- and middle-income regions, the focus was on diphtheria, tetanus and pertussis, and polio. Across all regions, most interventions were multi-component and the majority of strategies focused on raising knowledge and awareness. Thirteen relevant studies were used for the GRADE assessment that indicated evidence of moderate quality for the use of social mobilization, mass media, communication tool-based training for health-care workers, non-financial incentives and reminder/recall-based interventions. Overall, our results showed that multicomponent and dialogue-based interventions were most effective. However, given the complexity of vaccine hesitancy and the limited evidence available on how it can be addressed, identified strategies should be carefully tailored according to the target population, their reasons for hesitancy, and the specific context.

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

“…The effectiveness of interventions to increase immunisation uptake among children 48,[78][79][80][81][82] and adults 68,78,83,84 have also been reviewed and there are many examples of innovative health-and social-care provisions aimed at improving the health of Travellers. 17,18,85,86 Some target immunisation specifically (e.g.…”

Do changes in socio-demographic characteristics impact up-to-date immunization status between 3 and 24 months of age? A prospective study among an inner-city birth cohort in the United States

“…In particular, the perception of immunizations as a "social norm," religious beliefs, language, and vaccine hesitancy are likely additional factors influencing immunization patterns. 11,14,15,22,23 Though our analysis accounted for a range of candidate predictors, additional research in this area is warranted to advance our understanding of the mechanism connecting early immunization status with later immunization status.…”

“…These factors primarily center on maternal characteristics (e.g., race, marital status, education level, and income) and clinic type (e.g., community health centers, hospital clinics, and private practices), with more recent evidence about environmental influences (e.g., religious beliefs, language, social norms, and legal frameworks). [7][8][9][10][11] Taken together, these studies show children with low socioeconomic status and living in environments with high levels of community distrust are less likely to be UTD than other groups. [7][8][9][10][11] Little is known, however, regarding the relative importance of specific socio-demographic characteristics, including those that often change during early childhood, on immunization status by the end of the first 24 months of life.…”

“…[7][8][9][10][11] Taken together, these studies show children with low socioeconomic status and living in environments with high levels of community distrust are less likely to be UTD than other groups. [7][8][9][10][11] Little is known, however, regarding the relative importance of specific socio-demographic characteristics, including those that often change during early childhood, on immunization status by the end of the first 24 months of life. During this period, there is ample opportunity for changes in family structure (e.g., single vs. two-parent households, additional children in the household) that are often accompanied by altered parenting approaches or circumstances.…”

“…13 Given that contemporary debates about the risks and benefits of vaccinations are often highlighted in the media, the impact of parental health literacy and its potential interaction with social norms and health beliefs on vaccine receipt in early childhood merits investigation. 11,14,15 Understanding changes in the relative influence of these predictors of vaccination status through 24 months of age may advance our understanding of the potential impact and ideal focus of outreach and intervention campaigns, yielding a potential decreased need for catch-up vaccination regimens as well as improved herd immunity.…”