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Increasing Appropriate Vaccination: Community-Based Interventions Implemented in Combination

Task Force Finding

The Community Preventive Services Task Force recommends community-based interventions implemented in combination to increase vaccinations in targeted populations, on the basis of strong evidence of effectiveness in increasing vaccination rates.

The conclusion of strong evidence was based on findings from 18 studies that evaluated coordinated interventions to:

  • Increase community demand
  • Enhance access to vaccination services, and
  • Reduce missed opportunities by vaccination providers

In 13 of the 18 studies, the community-based effort combined one or more interventions to increase community demand for vaccinations with one or more interventions to enhance access to vaccination services.

The Task Force notes that implementing manual outreach and tracking or home visits can be resource-intensive and costly, relative to other options for increasing vaccination rates. Such interventions should be used only when there is demonstrated need, and resources are available.

Read the full Task Force Finding and Rationale Statement for details including implementation issues, possible added benefits, potential harms, and evidence gaps.

Intervention Definition

Community-based interventions implemented in combination involve the use of two or more coordinated interventions to increase vaccination rates within a targeted population. Efforts involve partnerships between community organizations, local government, and vaccination providers to implement and coordinate the following:

  • One or more interventions to increase community demand (client reminder and recall systems, manual outreach and tracking, client or community-wide education, client incentives, client-held paper immunization records, and case management)
  • One or more interventions to enhance access to vaccination services (expanded access in healthcare settings, home visits, and reduced client out-of-pocket costs)

Efforts may also include additional interventions directed at vaccination providers (e.g. provider assessment and feedback, provider education, and provider reminder systems).

About the Systematic Review

This Task Force finding is based on evidence from a Community Guide systematic review completed in 2010 (17 studies; search period 1980 - 2010) combined with more recent evidence (1 study, search period 2010 - 2012) The finding updates and replaces the 2010 finding for Community-Based Interventions Implemented in Combination.

This review was conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to increasing appropriate vaccination. Subscribe External Web Site Icon to be notified as new materials on this topic become available.

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Publication Status

Full peer-reviewed articles of this systematic review will be posted on the Community Guide website when published. Subscribe External Web Site Icon to be notified when we post these publications or other materials. See our library for previous Community Guide publications on this and other topics.



The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.

Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Increasing appropriate vaccination: community-based interventions implemented in combination (abbreviated). Last updated: MM/DD/YYYY.

Review completed: October 2014