Elsevier

Vaccine

Volume 33, Issue 25, 9 June 2015, Pages 2862-2880
Vaccine

Review
Parental reminder, recall and educational interventions to improve early childhood immunisation uptake: A systematic review and meta-analysis

https://doi.org/10.1016/j.vaccine.2015.04.085Get rights and content
Under a Creative Commons license
open access

Highlights

  • 28 trials involving 14,936 parent–child dyads examined immunisation uptake strategies.

  • The methodological quality of trials was generally low.

  • All parental interventions appear associated with improvements in uptake, although findings were inconsistent.

  • Parental reminder strategies significantly increase immunisation uptake.

  • Parental education may significantly increase uptake, but further research is needed.

Abstract

Vaccination is one of the most effective ways of reducing childhood mortality. Despite global uptake of childhood vaccinations increasing, rates remain sub-optimal, meaning that vaccine-preventable diseases still pose a public health risk. A range of interventions to promote vaccine uptake have been developed, although this range has not specifically been reviewed in early childhood. We conducted a systematic review and meta-analysis of parental interventions to improve early childhood (0–5 years) vaccine uptake. Twenty-eight controlled studies contributed to six separate meta-analyses evaluating aspects of parental reminders and education. All interventions were to some extent effective, although findings were generally heterogeneous and random effects models were estimated.

Receiving both postal and telephone reminders was the most effective reminder-based intervention (RD = 0.1132; 95% CI = 0.033–0.193). Sub-group analyses suggested that educational interventions were more effective in low- and middle-income countries (RD = 0.13; 95% CI = 0.05–0.22) and when conducted through discussion (RD = 0.12; 95% CI = 0.02–0.21). Current evidence most supports the use of postal reminders as part of the standard management of childhood immunisations. Parents at high risk of non-compliance may benefit from recall strategies and/or discussion-based forums, however further research is needed to assess the appropriateness of these strategies.

Keywords

Vaccination
Early childhood
Intervention
Recall and reminder
Education
Uptake

Cited by (0)