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Increasing Appropriate Vaccination: Provider Assessment and Feedback

Community Preventive Services Taskforce Task Force Finding and Rationale Statement (2015)

The Community Guide - N/A

Evidence Categories

  • Care setting: Not described
  • Population group: Adults
  • Intervention: Other Intervention
  • Outcome: Uptake of vaccinations
  • Outcome: Cost effectiveness

Type of Evidence

Systematic Review

Aims

"This report aimed to determine whether provider assessment and feedback programs when used alone or when combined with additional interventions increase vaccination rates adults and children."

Findings

The authors state:

"The Task Force finding is based on evidence from a Community Guide systematic review completed in 2008 (19 studies, search period 1997–2007) combined with more recent evidence (1 study, search period 2007–February 2012). Based on the combined evidence, the Task Force reaffirms its recommendation based on strong evidence of effectiveness. The Task Force considered evidence from 20 studies. Of these, 16 studies with 20 study arms provided common measurements of change in vaccination rates. The median increase of 9 percentage points (interquartile interval [IQI]: 3 to 14 percentage points). Fifteen study arms provided sufficient information to calculate the change in vaccination rates and showed a median increase of 18.0% (IQI: 9.5% to 24.0%). Seven study arms evaluated the impact of assessment and feedback for providers when implemented alone and found a median increase of 11 percentage points (IQI: 7 to 12 percentage points). Thirteen study arms evaluated provider assessment and feedback with additional interventions and observed a median increase of 6 percentage points (IQI: 3 to 18 percentage points). One additional study did not provide a common measurement of change in vaccination rates, and reported no change after implementation of intervention.

Three studies were included in the economic review (search period 1980–2012). Monetary values are reported in 2013 U.S. dollars. All three studies covered childhood series vaccines, with one based in Canada and the remaining two in the U.S. The size of the intervention group ranged from 1643 to 18,034 clients. The cost to implement the intervention ranged from $0.22 to $4 per child per year. One study estimated the cost per additional vaccinated child at $80."

Conclusions

The authors state:

"The Community Preventive Services Task Force recommends assessment and feedback for vaccination providers on the basis of strong evidence of effectiveness in increasing vaccination rates: (1) among adults and children; (2) when used alone or with additional interventions; and (3) across a range of settings and populations. While there was not enough evidence to determine which characteristics of assessment and feedback contributed most to its effectiveness, various strategies have been consistently effective in a wide range of contexts."