Interventions to increase influenza vaccination rates among people in the community aged 60 years and older
Citation: Thomas RE, Lorenzetti DL. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database of Systematic Reviews. 2018;(5):CD005188.
Language: Abstract available in EN, ES, FA, ZH. Full text available in EN.
Free to view: Yes.
Funding Sources: No external funding.
What is this? In this updated Cochrane review, the authors searched for randomised controlled trials of interventions to increase the uptake of influenza vaccination among community-dwelling people aged 60 years or older. They searched in December 2017 and found 61 trials (1,055,337 participants) plus one ongoing study.
What works: Reminders and recalls increased community demand for vaccines, as did patient education by nurses and pharmacists. Outreach by retired teachers, nurses, medical students, and receptionists was also effective. Home visits, group clinic visits, and free vaccination improved access to vaccines. Physician payments, physician reminders, clinic posters, chart reviews, and benchmarking rates to the top 10% of physicians improved the provision of vaccinations.
What doesn’t work: Interventions to increase staff vaccination rates did not improve community uptake. Individual studies showed that the enhancement of some interventions were no more effective than the single intervention. Ineffective examples were: the addition of postcards to posters, educational reminders to physicians in addition to mailed educational material, and educational outreach plus feedback to teams rather than written feedback.
What is uncertain: It was uncertain whether or not vaccination programmes for people aged 60 years or older reduced influenza or influenza-like illnesses (ILI).
Implications: The authors stated that while vaccination programmes for people aged 60 years and older may reduce influenza and influenza-like illnesses, there were insufficient data on complications. Policymakers and individuals should consider the likely benefits of reduced risk for influenza and ILI, uncertainty over complications, and possible increases in harm. Until the role of vaccines in preventing complications of influenza in older persons is clarified, more comprehensive and effective strategies for the control of acute respiratory infections should be investigated.
Other considerations: The authors of the review discussed their findings in the context of age.
This summary was written by Joly Ghanawi, checked by Surya Ramachandran and Sydney Johnson, and finalized by William Summerskill.