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Vaccination Programs: Provider Assessment and Feedback

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What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a Community Guide systematic review completed in 2008 pdf icon [PDF - 166 kB] (19 studies, search period 1997–2007) combined with more recent evidence (1 study, search period 2007–February 2012).

This review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice and policy related to increasing appropriate vaccination.

Context

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Summary of Results

More details about study results are available in the Task Force Finding and Rationale Statement pdf icon [PDF - 501 kB].

The systematic review included 20 studies.

  • Overall vaccination rates increased by a median of 9 percentage points (16 studies).
    • Provider assessment and feedback used alone increased vaccination rates by a median of 11 percentage points (7 study arms).
    • Provider assessment and feedback used in combination with additional interventions increased vaccination rates by a median of 6 percentage points (13 study arms).
  • The relative change in vaccination rates showed a median increase of 18.0% (15 study arms).
  • Overall vaccination rates among children increased by a median of 10.5 percentage points (8 studies with 10 study arms).
  • One study that did not provide a common measurement of change in vaccination rates reported no intervention effect.

Summary of Economic Evidence

More details about study results are available in the Task Force Finding and Rationale Statement pdf icon [PDF - 501 kB].

The economic evidence is based on three studies that looked at the childhood vaccination series (search period 1980 – 2012). Monetary values are reported in 2013 U.S. dollars.

  • The cost to implement the intervention ranged from $0.22 to $4 per child per year.
  • One study estimated the cost per additional vaccinated child at $80.
  • The size of the intervention group ranged from 1,643 to 18,034 clients.
  • Two studies were from the U.S. and one was from Canada.

Applicability

CPSTF findings should be applicable to children, adolescents, and adults from various populations and in various settings.

Evidence Gaps

Additional research and evaluation are needed to answer the following questions and fill existing gaps in the evidence base. (What are evidence gaps?)

  • How effective are these interventions for adolescent populations?
  • What is intervention effectiveness in communities with disparities in vaccination rates?
  • What are effectiveness, utility, and cost-effectiveness of provider assessment and feedback interventions that use regional or state-level immunization information systems (IIS)?

Study Characteristics

Evaluated interventions were conducted with children and adults in a wide range of settings and among different target populations.

Publications