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Vaccination Programs: Provider Reminders

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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 - 160 kB] (23 studies, search period 1997-2007) combined with more recent evidence (5 studies, 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

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 494 kB].

The systematic review included 28 studies.

  • Overall vaccination rates increased by a median of 10 percentage points (22 studies).
    • Provider reminders used alone increased vaccination rates by a median of 12 percentage points (7 studies).
    • Provider reminders used with additional interventions increased vaccination rates by a median of 9 percentage points (15 studies).
  • Of the six studies that did not provide a common measure of change for vaccination rates, five reported favorable results.

Summary of Economic Evidence

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 494 kB].

Four studies were included in the economic review (search period 1980 –2012). All monetary values are reported in 2013 U.S. dollars.

  • The median intervention cost was $7 per person per year (3 studies).
  • The median cost per additional vaccinated person was $309 (3 studies).
  • The cost tended to be higher for interventions that used a manual process instead of an immunization information system.
  • The median intervention group size was 2,910 clients (4 studies).
  • Three were from the U.S. and one was from Canada. Studies examined intervention effectiveness on uptake of influenza or pneumococcal vaccinations (2 studies), tetanus vaccinations (1 study), and the childhood series (1 study).

Applicability

Based on results of the review, CPSTF findings should be applicable to people of all ages from various populations and in a wide range of clinical 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?)

  • What are effectiveness, cost-effectiveness, and utility of system-level implementation of provider reminder interventions including regional or state-level immunization information systems (IIS)?
  • What are the strategies encourage regular and sustained use of reminder systems?
  • How effective are these interventions for adolescent populations?
  • What is the effectiveness of provider reminders in communities with disparities in vaccination rates?

Study Characteristics

  • Included studies were conducted in a wide range of clinical vaccination settings including private practices, community health centers, ambulatory care clinics, and hospitals.
  • Studies focused on uptake of different vaccinations including tetanus for adults and the childhood series.

Publications