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Published on: August 7, 2017
Primary care strategies to improve childhood immunisation uptake in developed countries: systematic review
Nia Williams1, Helen Woodward, Azeem Majeed
1Department of Primary Care and Public Health, Imperial College London , London W6 8RF , UK.
Insights
Parental and healthcare provider reminders significantly improve childhood immunisation rates in developed countries. These strategies, including recall systems, enhance vaccination uptake among preschool children.
Area of Science:
- Public Health
- Preventive Medicine
- Pediatrics
Background:
- Childhood immunisation is crucial for preventing infectious diseases.
- Optimizing immunisation uptake in preschool children remains a public health priority.
- Developed countries face challenges in achieving universal vaccination coverage.
Purpose of the Study:
- To systematically review strategies for enhancing immunisation uptake in preschool children.
- To identify effective interventions for increasing vaccination rates in developed nations.
Main Methods:
- Systematic review of 46 studies published between 1980 and 2009.
- Included randomized controlled trials, before-and-after trials, and controlled intervention trials.
- Focused on interventions targeting preschool children due for routine immunisations.
Main Results:
- Parental reminders increased immunisation rates in 34% of intervention arms.
- Provider-targeted strategies showed median increases: 7% (reminders), 8% (education), 19% (feedback).
- Various reminder and recall methods proved effective.
Conclusions:
- General practitioners play a key role in influencing parental immunisation decisions.
- Parental and healthcare provider reminders are effective strategies to improve immunisation rates.
- Primary care settings can successfully implement interventions to boost childhood vaccination.
Objectives:
To conduct a systematic review of strategies to optimize immunisation uptake within preschool children in developed countries.
Design:
Systematic review.
Setting:
Developed countries
Participants:
Preschool children who were due, or overdue, one or more of their routine primary immunisations.
Main Outcome Measures:
Increase in the proportion of the target population up to date with standard recommended universal vaccinations.
Results:
Forty-six studies were included for analysis, published between 1980 and 2009. Twenty-six studies were randomized controlled trials, 11 were before and after trials, and nine were controlled intervention trials. Parental reminders showed a statistically significant increase in immunisation rates in 34% of included intervention arms. These effects were reported with both generic and specific reminders and with all methods of reminders and recall. Strategies aimed at immunisation providers were also shown to improve immunisation rates with a median change in immunisation rates of 7% when reminders were used, 8% when educational programmes were used and 19% when feedback programmes were used.
Conclusion:
General practitioners are uniquely positioned to influence parental decisions on childhood immunisation. A variety of strategies studied in primary care settings have been shown to improve immunisation rates, including parental and healthcare provider reminders.
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