Vaccination Programs: Client Reminder and Recall Systems

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Findings and Recommendations

The Community Preventive Services Task Force (CPSTF) recommends client reminder and recall interventions to increase vaccination rates in children, adolescents, and adults.

The full CPSTF Finding and Rationale Statement and supporting documents for Vaccination Programs: Client Reminder and Recall Systems are available in The Community Guide Collection on CDC Stacks.

Intervention

Client reminder and recall interventions remind members of a target population that vaccinations are due (reminders) or late (recall). Reminders and recalls differ in content and are delivered by various methods (e.g., telephone, letter, postcard, text message). Most notices are tailored for individual clients and many include educational messages about the importance of vaccination.

About The Systematic Review

The CPSTF 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 (10 studies, search period 2007-2012). The finding updates and replaces the 2008 CPSTF finding for Client Reminder and Recall Systems.

Study Characteristics

  • Interventions used alone (14 studies) or with additional interventions (15 studies)
  • Conducted in United States (18 studies), Canada (3), Denmark (1), New Zealand (1), and United Kingdom (1)
  • Evaluated programs to address influenza, pneumococcal, DTP/DTaP, MMR, tetanus, and various childhood series

Summary of Results

Twenty-nine studies were included.

  • Overall vaccination rates increased by a median of 11 percentage points
    • Client reminder and recall used alone: median increase of 6 percentage points (14 studies)
    • Implemented with additional components: median increase of 12 percentage points (15 studies)

Summary of Economic Evidence

Evidence indicates client reminder and recall systems can reach large numbers of clients and increase vaccination rates with relatively few economic resources.

Twenty-four studies were included (search period 1980-2012). Monetary values in 2013 U.S. dollars.

  • Median intervention group size: 654 (23 studies)
  • Median cost per person per year: $2.13 (23 studies)
  • Median cost per additional person vaccinated: $15 (22 studies)

Applicability

Findings applicable to:

  • Children, adolescents, and adults
  • Various populations
  • Clinical and community settings at different levels from individual practice to entire communities
  • Programs using a range of intervention characteristics
  • Programs used alone or with additional components
  • Assorted vaccinations

Evidence Gaps

  • How effective are client reminders that use emerging communication technologies such as text messaging?
  • Are interventions implemented by individual providers or healthcare systems, or through immunization information systems (IIS) effective? If so, are they cost-effective?
  • How effective are interventions with adolescent populations?
  • How effective are client reminders in communities with disparities in vaccination rates?

Implementation Considerations and Resources

Client reminder or recall systems can be included in two intervention approaches recommended by CPSTF:

Immunization information systems can be used to generate client reminder or recall notices.

Client reminder and recall systems can be used for vaccination and additional preventive care notices.

Crosswalks