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Quality improvement programs for adult immunization: a scoping literature review
Matthew Z Dudley1, Amimah F Asif2, Ebony S Thomas2
1Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Vaccine
|July 16, 2026
Summary
Quality improvement programs significantly boost adult immunization rates, particularly for influenza and pneumococcal vaccines. These programs commonly use patient and provider reminders and education to enhance vaccine uptake.
Area of Science:
- Public Health
- Healthcare Quality Improvement
- Vaccinology
Background:
- Pediatric immunization quality improvement (QI) programs are established, but adult immunization strategies require clearer definition.
- Practice-level approaches for adult vaccination differ from pediatric methods.
Purpose of the Study:
- To systematically identify and summarize adult immunization QI programs.
- To analyze strategies used in published and unpublished literature for adult vaccination QI.
Main Methods:
- Comprehensive literature search across PubMed, Embase, ClinicalTrials.gov, and NDLTD.
- Screening and data extraction using Covidence for studies on U.S. adult immunization QI programs.
Main Results:
- 272 studies were included, focusing on influenza and pneumococcal vaccines.
- Common QI interventions included patient education (49%), patient reminders (38%), provider reminders (36%), and provider education (35%).
- 81% of studies showed significant increases in adult vaccine coverage, with high success rates across study designs.
Conclusions:
- Adult immunization QI programs, often employing reminders and education, effectively increase vaccine coverage.
- Further research is necessary to pinpoint the most impactful QI components for adult vaccination.
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