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Increasing Appropriate Vaccination: Health Care System-Based Interventions Implemented in Combination

Task Force Finding

The Community Preventive Services Task Force recommends health care system-based interventions implemented in combination on the basis of strong evidence of effectiveness in increasing vaccination rates in targeted client populations.

Based on findings from 37 of the 64 included studies, the Task Force further recommends a combination that includes the following.

At least one intervention to increase client demand for vaccinations, such as:

And one or more interventions that address either, or both, of the following strategies:

Interventions listed as examples for each strategy were those that showed the greatest effect on vaccination rates.

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

Intervention Definition

Health care system-based interventions implemented in combination involve the use of two or more coordinated interventions to increase vaccination rates within a targeted client population. Interventions are implemented primarily in health care settings, although efforts may include additional activities within the community. Specific interventions may include client reminder and recall systems; clinic-based client education; expanded access in health care settings; provider assessment and feedback; provider reminders; and standing orders. The selection and implementation of coordinated interventions may result from an overall quality improvement effort in a health care setting.

About the Systematic Review

The Task Force finding is based on evidence from a Community Guide systematic review completed in 2010 (62 studies; search period 1980-2010) combined with more recent evidence (2 studies; search period 2010-February 2012). The finding updates and replaces the 2010 finding for Health System-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.

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: health care system-based interventions implemented in combination (abbreviated). Last updated: MM/DD/YYYY.

Review completed: October 2014