以接收者为中心的干预措施,以增加高收入和中等收入国家接种疫苗:系统审查和网络元分析
Sarah R Davies1,2, Annabel L Davies1, Julian P T Higgins1,2,3
1Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
多元组件,获取和可负担性干预措施显著提高了疫苗接种率. 然而,COVID-19大流行可能降低了可负担性和多组件策略的有效性,需要持续监测和优化.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 证据综合 证据综合
背景情况:
- 疫苗接种量在全球范围内有所下降,低于关键值,由COVID-19大流行加剧.
- 有大量证据表明,针对接种疫苗的患者进行干预.
- 本研究综合了有关这些干预措施比较有效性的证据.
研究的目的:
- 为了比较不同疫苗接种干预措施的有效性.
- 根据年龄组评估干预有效性的变化.
- 评估COVID-19大流行对干预有效性的影响.
主要方法:
- 系统审查和贝叶斯随机效应网络元分析 (NMA) 来自高收入和中高收入国家的随机对照试验 (RCT) (2000-2024).
- 干预措施分为六种类型:获取,负担能力,教育,提醒,教育和提醒以及多组件.
- 使用Cochrane RoB 2评估的偏差风险;使用CINeMA评估的证据确定性.
主要成果:
- 与对照组相比,所有六个干预类别的疫苗接种率都较好.
- 多组件 (OR:2.09),负担能力 (OR: 1.87) 和获取 (OR: 1.74) 的干预措施是最有效的.
- 与2020年之前相比,可负担性和多组件干预措施在2020年后的效果似乎较低,而其他干预措施保持稳定.
结论:
- 疫苗接种计划应优先考虑使疫苗易于使用,方便和负担得起.
- 进一步的研究应该集中在优化获取和可负担性干预措施上.
- COVID-19大流行对干预有效性的影响需要持续监测.
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