Anelisa Jaca1, Lindi Mathebula2, Arthur Iweze2, Elizabeth Pienaar2, Charles S Wiysonge3. 1. Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. Electronic address: anelisa.jaca@mrc.ac.za. 2. Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa. 3. Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Abstract
BACKGROUND: Missed opportunities for vaccination (MOVs) occur when persons eligible for vaccination visit a health facility and do not get the vaccines they need. We conducted a systematic review to assess effects of interventions for reducing MOVs. METHODS: We searched PubMed, Scopus, and the Cochrane Central Register of Controlled Trials in April 2017. Three authors independently screened search outputs, reviewed potentially eligible papers, assessed risk of bias, and extracted data; resolving disagreements by consensus. We expressed study results as risk ratios (RR) with 95% confidence intervals (CI) and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. RESULTS: Six studies (five trials and one cohort study) met our inclusion criteria, all conducted in the United States of America. All six studies had various limitations and were classified as having a high risk of bias. We found moderate certainty evidence that the following interventions probably improve vaccination coverage: patient education (RR 1.92, 95% CI 1.38-2.68), patient tracking using community health workers (RR 1.18, 95% CI 1.11-1.25), and patient tracking and provider prompts (RR 1.24, 95% CI 1.18-1.31). In addition, we found low certainty evidence that concurrent interventions targeting health-facility (education, prompts, and audit and feedback) and family settings (phone calls) may increase vaccination coverage (RR 1.25, 95% CI 1.08-1.46). CONCLUSIONS: The currently available evidence suggests that patient education, patient tracking, outreach sessions, and provider prompts reduce missed opportunities for vaccination and improve vaccination coverage. Rigorous studies are required to confirm these findings and increase the certainty of the current evidence base. WHO is currently coordinating efforts to generate such evidence, especially from low-income and middle-income countries, and it is likely that the data will be available in the next few years.
BACKGROUND: Missed opportunities for vaccination (MOVs) occur when persons eligible for vaccination visit a health facility and do not get the vaccines they need. We conducted a systematic review to assess effects of interventions for reducing MOVs. METHODS: We searched PubMed, Scopus, and the Cochrane Central Register of Controlled Trials in April 2017. Three authors independently screened search outputs, reviewed potentially eligible papers, assessed risk of bias, and extracted data; resolving disagreements by consensus. We expressed study results as risk ratios (RR) with 95% confidence intervals (CI) and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. RESULTS: Six studies (five trials and one cohort study) met our inclusion criteria, all conducted in the United States of America. All six studies had various limitations and were classified as having a high risk of bias. We found moderate certainty evidence that the following interventions probably improve vaccination coverage: patient education (RR 1.92, 95% CI 1.38-2.68), patient tracking using community health workers (RR 1.18, 95% CI 1.11-1.25), and patient tracking and provider prompts (RR 1.24, 95% CI 1.18-1.31). In addition, we found low certainty evidence that concurrent interventions targeting health-facility (education, prompts, and audit and feedback) and family settings (phone calls) may increase vaccination coverage (RR 1.25, 95% CI 1.08-1.46). CONCLUSIONS: The currently available evidence suggests that patient education, patient tracking, outreach sessions, and provider prompts reduce missed opportunities for vaccination and improve vaccination coverage. Rigorous studies are required to confirm these findings and increase the certainty of the current evidence base. WHO is currently coordinating efforts to generate such evidence, especially from low-income and middle-income countries, and it is likely that the data will be available in the next few years.
Authors: Sara Cooper; Bey-Marrié Schmidt; Evanson Z Sambala; Alison Swartz; Christopher J Colvin; Natalie Leon; Charles S Wiysonge Journal: Cochrane Database Syst Rev Date: 2021-10-27
Authors: Fiona Ecarnot; Gaetano Crepaldi; Philippe Juvin; John Grabenstein; Giuseppe Del Giudice; Litjen Tan; Susan O'Dwyer; Susanna Esposito; Xavier Bosch; Gaetan Gavazzi; John Papastergiou; Jacques Gaillat; Robert Johnson; Marco Fonzo; Andrea Rossanese; Caterina Suitner; Jane Barratt; Alberta di Pasquale; Stefania Maggi; Jean-Pierre Michel Journal: BMC Public Health Date: 2019-12-18 Impact factor: 3.295
Authors: Malavika Tampi; Alonso Carrasco-Labra; Kelly K O'Brien; Martha Velandia-González; Romina Brignardello-Petersen Journal: Rev Panam Salud Publica Date: 2022-06-21