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A systematic review of strategies for reducing missed opportunities for vaccination

dc.contributor.authorJaca, Anelisaen_ZA
dc.contributor.authorMathebula, Lindien_ZA
dc.contributor.authorIweze, Arthuren_ZA
dc.contributor.authorPienaar, Elizabethen_ZA
dc.contributor.authorWiysonge, Charles S.en_ZA
dc.date.accessioned2019-11-05T06:26:06Z
dc.date.available2019-11-05T06:26:06Z
dc.date.issued2018
dc.identifier.citationJaca, A. et al. 2018. A systematic review of strategies for reducing missed opportunities for vaccination. Vaccine, 36(21):2921-2927, doi:10.1016/j.vaccine.2018.04.028.
dc.identifier.issn0264-410X (online)
dc.identifier.otherdoi:10.1016/j.vaccine.2018.04.028
dc.identifier.urihttp://hdl.handle.net/10019.1/106782
dc.descriptionCITATION: Jaca, A. et al. 2018. A systematic review of strategies for reducing missed opportunities for vaccination. Vaccine, 36(21):2921-2927, doi:10.1016/j.vaccine.2018.04.028.
dc.descriptionThe original publication is available at https://www.sciencedirect.com/journal/vaccine
dc.description.abstractBackground: Missed opportunities for vaccination (MOVs) occur when persons eligible for vaccination visit a health facility and do not get the vaccines they need. We conducted a systematic review to assess effects of interventions for reducing MOVs. Methods: We searched PubMed, Scopus, and the Cochrane Central Register of Controlled Trials in April 2017. Three authors independently screened search outputs, reviewed potentially eligible papers, assessed risk of bias, and extracted data; resolving disagreements by consensus. We expressed study results as risk ratios (RR) with 95% confidence intervals (CI) and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Results: Six studies (five trials and one cohort study) met our inclusion criteria, all conducted in the United States of America. All six studies had various limitations and were classified as having a high risk of bias. We found moderate certainty evidence that the following interventions probably improve vaccination coverage: patient education (RR 1.92, 95% CI 1.38–2.68), patient tracking using community health workers (RR 1.18, 95% CI 1.11–1.25), and patient tracking and provider prompts (RR 1.24, 95% CI 1.18–1.31). In addition, we found low certainty evidence that concurrent interventions targeting health-facility (education, prompts, and audit and feedback) and family settings (phone calls) may increase vaccination coverage (RR 1.25, 95% CI 1.08–1.46). Conclusions: The currently available evidence suggests that patient education, patient tracking, outreach sessions, and provider prompts reduce missed opportunities for vaccination and improve vaccination coverage. Rigorous studies are required to confirm these findings and increase the certainty of the current evidence base. WHO is currently coordinating efforts to generate such evidence, especially from low-income and middle-income countries, and it is likely that the data will be available in the next few years.en_ZA
dc.description.urihttps://www.sciencedirect.com/science/article/pii/S0264410X18305115
dc.format.extent7 pages
dc.language.isoen_ZAen_ZA
dc.publisherElsevier
dc.subjectImmunizationen_ZA
dc.subjectVaccinationen_ZA
dc.subjectSystematic reviews (Medical research)en_ZA
dc.titleA systematic review of strategies for reducing missed opportunities for vaccinationen_ZA
dc.typeArticleen_ZA
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyright


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