Categorising interventions to enhance vaccine uptake or reduce vaccine hesitancy in the United Kingdom: A systematic review and meta-analysis

Kafadar, Aysegul Humeyra; Sabatini, Serena; Jones, Katy A.; Dening, Tom

Abstract

Background: Vaccination is one of the most important public health interventions to combat infectious disease. However, vaccine hesitancy prevents us reaching the global target of vaccine uptake (e.g., 75 % of influenza vaccination in at-risk groups). This review summarises all interventions designed to reduce vaccine hesitancy and increase vaccine uptake for all types of vaccines offered to adults (≥18 years) since 2000, in the United Kingdom (UK). Methods: PubMed, Cochrane Reviews, CINAHL EBSCO, and Scopus were searched (September 19, 2023). The PRISMA Checklist 2020 was used for quality checking. Data from randomised-controlled trials (RCTs) were analysed with a meta-analysis and narrative analysis. In all included studies, a narrative synthesis was undertaken to summarise, evaluate and characterise the reported behaviour change interventions into four categories: organisational-level, public demand, provider-level, and multidimensional interventions. Findings are evaluated based on the MINDSPACE framework to understand the possible psychological mechanisms underpinning the interventions. Findings: A total of 9,842 articles were identified, 50 met the inclusion criteria. Interventions aimed to boost vaccine uptake or reduce hesitancy of influenza (50 %), COVID-19 (32 %), hepatitis B (6 %), and other vaccines. A meta-analysis was conducted for nine RCTs evaluating various interventions impact on vaccine uptake. The pooled effect was statistically significant (OR with 95 % CI = 1.23 [1.07 to 1.41]). Providing certain and understandable information and using a reminder system with personal messages or letters were the most frequently documented and effective interventions to enhance public demand (enhance information salience). Organisational level interventions intended to make vaccinations more accessible (e.g., providing vaccination at alternative places or times). Provider-oriented interventions encouraged healthcare workers to focus on reducing vaccine hesitancy or enhancing vaccine uptake. Interpretation: Among the main MINDSPACE techniques, enhancing the salience of vaccine information and priming vaccination by improving access were identified as the most applied and effective interventions in the UK.

Citation

Kafadar, A. H., Sabatini, S., Jones, K. A., & Dening, T. (2024). Categorising interventions to enhance vaccine uptake or reduce vaccine hesitancy in the United Kingdom: A systematic review and meta-analysis. Vaccine, 42(25), Article 126092. https://doi.org/10.1016/j.vaccine.2024.06.059

• Journal Article Type: Review
• Acceptance Date: Jun 25, 2024
• Online Publication Date: Jul 2, 2024
• Publication Date: Nov 14, 2024
• Deposit Date: Jun 27, 2024
• Publicly Available Date: Jul 3, 2025
• Journal: Vaccine
• Electronic ISSN: 1873-2518
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 42
• Issue: 25
• Article Number: 126092
• DOI: https://doi.org/10.1016/j.vaccine.2024.06.059
• Public URL: https://nottingham-repository.worktribe.com/output/36571417
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0264410X24007333
• Additional Information: This article is maintained by: Elsevier; Article Title: Categorising interventions to enhance vaccine uptake or reduce vaccine hesitancy in the United Kingdom: A systematic review and meta-analysis; Journal Title: Vaccine; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.vaccine.2024.06.059; Content Type: article; Copyright: © 2024 The Author(s). Published by Elsevier Ltd.