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Interventions to Improve Vaccination Uptake Among Adults: A Systematic Review and Meta-Analysis
Anelisa Jaca1, Lindi Mathebula1, Thobile Malinga1
1Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa.
Vaccines
|August 28, 2025
Summary
Adult vaccination uptake can be improved through targeted interventions. Letter reminders and educational outreach are effective strategies to increase immunization rates in adults, enhancing public health outcomes.
Area of Science:
- Public Health
- Epidemiology
- Preventive Medicine
Background:
- Immunization is crucial for preventing infectious diseases, with successes like smallpox eradication and polio reduction.
- Vaccination significantly lowers morbidity and mortality rates globally.
- Adult vaccination remains an important area for public health intervention.
Purpose of the Study:
- To review interventions aimed at increasing adult vaccination uptake.
- To assess the effectiveness of various strategies in promoting adult immunization.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) from multiple databases (CENTRAL, Embase, Medline, PubMed, Web of Science, Global Index Medicus).
- Search updated through November 2024, including studies regardless of publication status or language.
- Meta-analysis using a random-effects model, with evidence quality assessed by GRADE.
Main Results:
- 35 RCTs involving 403,709 adults were included, primarily focusing on influenza vaccination.
- Interventions like letter reminders (RR: 1.75), educational materials (RR: 1.88), and outreach (RR: 1.87) showed increased vaccination uptake.
- Pooled results for influenza vaccination interventions indicated a risk ratio of 1.41 (95% CI: 1.15, 1.73).
Conclusions:
- Letter reminders and educational interventions are effective in boosting adult vaccination rates.
- Targeted recipient-focused strategies enhance immunization uptake compared to control groups.
- Further research may explore optimal delivery methods for these interventions.
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