447 Interventions effective in increasing influenza vaccination rates

February 09, 2015

written by Brian R McAvoy

Clinical question
How effective are access, provider, system and societal interventions in increasing the uptake of influenza vaccination in people aged 60 years and older in the community?

Bottom line
Effective interventions for increasing community demand were a letter plus leaflet/postcard (compared with a letter), nurses/pharmacists educating plus vaccinating patients, a phone call from a senior, a telephone invitation rather than clinic drop-in, free groceries lottery and nurses educating and vaccinating patients. Effective interventions for enhancing vaccination access were home visits (compared with clinic invitation), free vaccine and patient group visits. Effective provider/system interventions were paying physicians, reminding physicians about all their patients, posters plus postcards, chart review/feedback and educational outreach/feedback.

Caveat
Trials did not report adverse events. There were no trials of interventions at a societal level. A key problem was measuring how complete the assessment of influenza vaccination was, as in most of the US studies it was possible for participants to receive vaccination at walk-in clinics and during campaigns, instead of their regular clinics; some studies did not perform independent verification of the accuracy and completeness of their clinic records or financial billings.

Context
Many health authorities recommend influenza vaccination of older people. However, vaccination uptake in people aged 60 and older varies across countries, socioeconomic and health-risk groups. It is important to identify effective interventions to increase influenza vaccination uptake.

Cochrane Systematic Review
Thomas RE, Lorenzetti DI. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Reviews, 2014, Issue 7. Art. No.: CD005188.DOI: 10.1002/14651858. CD005188.pub3. This review contains 57 studies involving 896,531 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.