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Systematic Review
This report aimed to determine whether interventions that reduce client out-of-pocket costs used alone or combined with additional interventions increase vaccination rates among people of all ages in a range of settings and populations.
The authors state:
"This Task Force finding is based on evidence from a Community Guide systematic review completed in 2009 (15 studies; search period 1997 - 2009) combined with more recent evidence (5 studies, search period 2009 - 2012). Based on the combined evidence, the Task Force reaffirms its recommendation based on strong evidence of effectiveness. Eleven studies provided a common measurement of change in vaccination rates and showed a median increase of 22 percentage points (interquartile interval [IQI]: 6 to 33 percentage points). Six studies examined the impact of reducing client out-of-pocket costs alone (median increase of 28 percentage points; IQI: 2 to 47 percentage points) and 5 studies examined reducing client out-of-pocket costs as part of a multi-component strategy (median increase of 20 percentage points; IQI: 6 to 20 percentage points). The nine qualifying studies that did not provide a common measurement of change also reported overall increases in vaccinations received or administered.
The economic review includes three studies (search period 1980 – 2012): two that reduced out-of-pocket costs for influenza vaccinations and one that addressed the childhood series. Monetary values are reported in 2013 US dollars. The two influenza studies estimated intervention cost at $35 and $54 per person per year, resulting in $15,050 per life year saved and $114 per additional person vaccinated, respectively. Another study used modeling to report that eliminating out-of-pocket costs for vaccination series given to children born in the state of Georgia during 2003 would cost $221.56 per child and $3165.18 per additional vaccinated child."
The authors state:
"The Community Preventive Services Task Force recommends interventions that reduce client out-of-pocket costs based on strong evidence of effectiveness in improving vaccination rates. The effectiveness of these interventions has been demonstrated among children, adolescents, and adults, in a range of settings and populations, when applied in varying levels of scale from individual clinical settings to statewide programs to national efforts, and whether used alone or as part of a multi-component intervention."