Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 20;7(7):CD013706.
doi: 10.1002/14651858.CD013706.pub2.

Healthcare workers' perceptions and experiences of communicating with people over 50 years of age about vaccination: a qualitative evidence synthesis

Claire Glenton  1   2 , Benedicte Carlsen  3 , Simon Lewin  1   4 , Manuela Dominique Wennekes  5   6 , Brita Askeland Winje  1   7 , Renske Eilers  5 ; VITAL consortium  8
Affiliations

Healthcare workers' perceptions and experiences of communicating with people over 50 years of age about vaccination: a qualitative evidence synthesis

Claire Glenton et al. Cochrane Database Syst Rev. .

Abstract

Background: Infectious diseases are a major cause of illness and death among older adults. Vaccines can prevent infectious diseases, including against seasonal influenza, pneumococcal diseases, herpes zoster and COVID-19. However, the uptake of vaccination among older adults varies across settings and groups. Communication with healthcare workers can play an important role in older people's decisions to vaccinate. To support an informed decision about vaccination, healthcare workers should be able to identify the older person's knowledge gaps, needs and concerns. They should also be able to share and discuss information about the person's disease risk and disease severity; the vaccine's effectiveness and safety; and practical information about how the person can access vaccines. Therefore, healthcare workers need good communication skills and to actively keep up-to-date with the latest evidence. An understanding of their perceptions and experiences of this communication can help us train and support healthcare workers and design good communication strategies.

Objectives: To explore healthcare workers' perceptions and experiences of communicating with older adults about vaccination.

Search methods: We searched MEDLINE, CINAHL and Scopus on 21 March 2020. We also searched Epistemonikos for related reviews, searched grey literature sources, and carried out reference checking and citation searching to identify additional studies. We searched for studies in any language.

Selection criteria: We included qualitative studies and mixed-methods studies with an identifiable qualitative component. We included studies that explored the perceptions and experiences of healthcare workers and other health system staff towards communication with adults over the age of 50 years or their informal caregivers about vaccination.

Data collection and analysis: We extracted data using a data extraction form designed for this review. We assessed methodological limitations using a list of predefined criteria. We extracted and assessed data regarding study authors' motivations for carrying out their study. We used a thematic synthesis approach to analyse and synthesise the evidence. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We examined each review finding to identify factors that may influence intervention implementation and we developed implications for practice.

Main results: We included 11 studies in our review. Most studies explored healthcare workers' views and experiences about vaccination of older adults more broadly but also mentioned communication issues specifically. All studies were from high-income countries. The studies focused on doctors, nurses, pharmacists and others working in hospitals, clinics, pharmacies and nursing homes. These healthcare workers discussed different types of vaccines, including influenza, pneumococcal and herpes zoster vaccines. The review was carried out before COVID-19 vaccines were available. We downgraded our confidence in several of the findings from high confidence to moderate, low or very low confidence. One reason for this was that some findings were based on only small amounts of data. Another reason was that the findings were based on studies from only a few countries, making us unsure about the relevance of these findings to other settings. Healthcare workers reported that older adults asked about vaccination to different extents, ranging from not asking about vaccines at all, to great demand for information (high confidence finding). When the topic of vaccination was discussed, healthcare workers described a lack of information, and presence of misinformation, fears and concerns about vaccines among older adults (moderate confidence). The ways in which healthcare workers discussed vaccines with older adults appeared to be linked to what they saw as the aim of vaccination communication. Healthcare workers differed among themselves in their perceptions of this aim and about their own roles and the roles of older adults in vaccine decisions. Some healthcare workers thought it was important to provide information but emphasised the right and responsibility of older adults to decide for themselves. Others used information to persuade and convince older adults to vaccinate in order to increase 'compliance' and 'improve' vaccination rates, and in some cases to gain financial benefits. Other healthcare workers tailored their approach to what they believed the older adult needed or wanted (moderate confidence). Healthcare workers believed that older adults' decisions could be influenced by several factors, including the nature of the healthcare worker-patient relationship, the healthcare worker's status, and the extent to which healthcare workers led by example (low confidence). Our review also identified factors that are likely to influence how communication between healthcare workers and older adults take place. These included issues tied to healthcare workers' views and experiences regarding the diseases in question and the vaccines; as well as their views and experiences of the organisational and practical implementation of vaccine services.

Authors' conclusions: There is little research focusing specifically on healthcare workers' perceptions and experiences of communication with older adults about vaccination. The studies we identified suggest that healthcare workers differed among themselves in their perceptions about the aim of this communication and about the role of older adults in vaccine decisions. Based on these findings and the other findings in our review, we have developed a set of questions or prompts that may help health system planners or programme managers when planning or implementing strategies for vaccination communication between healthcare workers and older adults.

PubMed Disclaimer

Conflict of interest statement

CG: no financial conflicts of interest. CG is an EPOC editor but was not involved in the editorial process for this review.

BC: no financial conflicts of interest.

SL: no financial conflicts of interest. SL is the Joint Co‐ordinating Editor for EPOC but was not involved in the editorial process for this review.

MW: no financial conflicts of interest.

BAW: no financial conflicts of interest.

RE: no financial conflicts of interest. RE was a co‐author on one of the included papers and was, therefore, excluded from the screening, data extraction and assessment of this paper.

Several non‐financial issues, including personal, political and academic factors, could have influenced the review authors' input when conducting this review. The review authors have discussed this further in the sections on reflexivity in the 'Methods' and 'Result's sections.

Figures

1
1
Study flow diagram.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD013706

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Badertscher 2012 {published data only}
    1. Badertscher N, Morell S, Rosemann T, Tandjung R. General practitioners' experiences, attitudes, and opinions regarding the pneumococcal vaccination for adults: a qualitative study. International Journal of General Medicine 2012;5:967-74. - PMC - PubMed
Eilers 2015 {published data only}
    1. Eilers R, Krabbe PF, Melker HE. Attitudes of Dutch general practitioners towards vaccinating the elderly: less is more? BMC Family Practice 2015;16:1-7. - PMC - PubMed
Ellen 2018 {published data only}
    1. Ellen M. Factors that influence influenza vaccination rates among the elderly: nurses' perspectives. Journal of Nursing Management 2018;26(2):158-66. - PubMed
Hinshaw 2011 {published data only}
    1. Hinshaw D, Chandran AU. Evaluation of a geriatric inpatient influenza immunization program. American Journal of Infection Control 2011;39(4):342-4. - PubMed
Huston 2019 {published data only}
    1. Huston SA Ha HD, Hohmann LA, Hastings TJ, Garza KB, Westrick SC. Qualitative Investigation of Community Pharmacy Immunization Enhancement Program Implementation. Journal of Pharmacy Technology 2019;35(5):208-18. - PMC - PubMed
Hutt 2010 {published data only}
    1. Hutt E, Radcliff TA, Oman KS, Fink R, Ruscin JM, Linnebur S, et al. Impact of NHAP guideline implementation intervention on staff and resident vaccination rates. Journal of the American Medical Directors Association 2010;11(5):365-70. - PubMed
Lasser 2008 {published data only}
    1. Lasser KE, Kelly B, Maier J, Murillo J, Hoover S, Isenberg K, et al. Discussions about preventive services: a qualitative study. BMC Family Practice 2008;9(49):1-11. - PMC - PubMed
Lehmann 2014 {published data only}
    1. Lehmann BA, Ruiter RA, Wicker S, Dam D, Kok G. "I don't see an added value for myself": a qualitative study exploring the social cognitive variables associated with influenza vaccination of Belgian, Dutch and German healthcare personnel. BMC Public Health 2014;14(407):1-11. - PMC - PubMed
Raftopoulos 2008 {published data only}
    1. Raftopoulos V. Attitudes of nurses in Greece towards influenza vaccination. Nursing Standard 2008;23(4):35-42. - PubMed
Wray 2007 {published data only}
    1. Wray RJ, Jupka K, Ross W, Dotson D, Whitworth AR, Jacobsen H. How can you improve vaccination rates among older African Americans? Journal of Family Practice 2007;56(11):925-9. - PubMed
Zaouk 2019 {published data only}
    1. Zaouk H, Green JJ, Leask J. Immunisation status screening in the emergency department: why are we forgetting the elderly? Australasian Emergency Care 2019;23:23. - PubMed

References to studies excluded from this review

Braxton 2010 {published data only}
    1. Braxton JC. Do multiple interventions improve influenza vaccination compliance rates among nursing staff at the Hampton Veterans Administration Medical Center? University of Virginia 2010:169.
Clarke 2007 {published data only}
    1. Clarke C. Understanding Influenza Vaccine Behavior in Healthcare Workers: the Role of Information Seeking and Processing [MSc thesis]. New York (NY): Cornell University, 2007.
Cutrona 2016 {published data only}
    1. Cutrona SL, Sreedhara M, Goff SL, Fisher LD, Preusse P, Jackson M, et al. Improving rates of influenza vaccination through electronic health record portal messages, interactive voice recognition calls and patient-enabled electronic health record updates: protocol for a randomized controlled trial. JMIR Research Protocols 2016;5(2):e56. - PMC - PubMed
Davis 2005 {published data only}
    1. Davis MM, Halasyamani LK, Sneller VP, Bishop KR, Clark SJ. Provider response to different formats of the adult immunization schedule. American Journal of Preventive Medicine 2005;29(1):34-40. - PubMed
Fisher 2019 {published data only}
    1. Fisher MP, Gurfinkel D, Szilagyi PG, Saville A, Albertin C, Breck A, et al. Supporting and sustaining centralized reminder/recall for immunizations: qualitative insights from stakeholders. Vaccine 2019;37(44):6601-8. - PMC - PubMed
Ho 2016 {published data only}
    1. Ho J, Odhiambo G, Meng'anyi LW, Musuva RM, Mule JM, Alaly ZS, et al. Evaluation of medicine retail outlets for sale of typhoid fever vaccine among adults in two urban and rural settings in western Kenya: a proof-of-concept study. BMC Health Services Research 2016;16(1):527. - PMC - PubMed
Hurley 2019 {published data only}
    1. Hurley LP, Beaty B, Lockhart S, Gurfinkel D, Dickinson LM, Roth H, et al. Randomized controlled trial of centralized vaccine reminder/recall to improve adult vaccination rates in an accountable care organization setting. Preventive Medicine Reports 2019;15:100893. - PMC - PubMed
Kulczyck 2017 {published data only}
    1. Kulczyck A, Wensel TM, Hogue M. Practices, challenges, and opportunities to improving pneumococcal immunization in working-age, at-risk adults through community pharmacies. Infectious Diseases in Clinical Practice 2017;25(1):23-8.
Landis 1995 {published data only}
    1. Landis S, Scarbrough ML. Using a vaccine manager to enhance in-hospital vaccine administration. Journal of Family Practice 1995;41(4):364-9. - PubMed
MacDougall 2015a {published data only}
    1. MacDougall D, Halperin BA, MacKinnon-Cameron D, Li L, McNeil SA, Langley JM, et al. Universal tetanus, diphtheria, acellular pertussis (Tdap) vaccination of adults: what Canadian health care providers know and need to know. Human Vaccines & Immunotherapeutics 2015;11(9):2167-79. - PMC - PubMed
MacDougall 2015b {published data only}
    1. MacDougall DM, Halperin BA, MacKinnon-Cameron D, Li L, McNeil SA, Langley JM, et al. The challenge of vaccinating adults: attitudes and beliefs of the Canadian public and healthcare providers. BMJ Open 2015;5(9):e009062. - PMC - PubMed
MacDougall 2016 {published data only}
    1. MacDougall D, Halperin BA, Isenor J, MacKinnon-Cameron D, Li L, McNeil SA, et al. Routine immunization of adults by pharmacists: attitudes and beliefs of the Canadian public and health care providers. Human Vaccines & Immunotherapeutics 2016;12(3):623-31. - PMC - PubMed
Manca 2018a {published data only}
    1. Manca T. Fear, rationality, and risky others: a qualitative analysis of physicians' and nurses' accounts of popular vaccine narratives. Technology in Society 2018;55:119-25.
Manca 2018b {published data only}
    1. Manca T. "One of the greatest medical success stories:" physicians and nurses' small stories about vaccine knowledge and anxieties. Social Science & Medicine 2018;196:182-9. - PubMed
Marcu 2015 {published data only}
    1. Marcu A, Rubinstein H, Michie S, Yardley L. Accounting for personal and professional choices for pandemic influenza vaccination amongst English healthcare workers. Vaccine 2015;33(19):2267-72. - PubMed
Martinez 2016 {published data only}
    1. Martinez L, Tugaut B, Raineri F, Arnould B, Seyler D, Arnould P, et al. The commitment of French general practitioners to vaccination: the DIVA study (Determinants of Vaccination Intentions). Sante Publique (Vandoeuvre-Les-Nancey) 2016;28(1):19-32. - PubMed
Mueller 2007 {published data only}
    1. Mueller MR, Hill L, Fontanesi J, Kopald D. Disagreement on immunization recommendations an analysis of lay-clinician interaction. Journal of Applied Social Science 2007;1(2):69-76.
Nowalk 2012 {published data only}
    1. Nowalk MP, Nutini J, Raymund M, Ahmed F, Albert SM, Zimmerman RK. Evaluation of a toolkit to introduce standing orders for influenza and pneumococcal vaccination in adults: a multimodal pilot project. Vaccine 2012;30(41):5978-82. - PubMed
Omura 2014 {published data only}
    1. Omura J, Buxton J, Kaczorowski J, Catterson J, Li J, Derban A, et al. Immunization delivery in British Columbia: perspectives of primary care physicians. Canadian Family Physician 2014;60(3):e187-93. - PMC - PubMed
Seymour 2014 {published data only}
    1. Seymour M. Giving vaccination a shot: describing seasonal influenza vaccine hesitancy at public health – Seattle & King County [MPH thesis]. Washington (DC): University of Washington, 2014.
Willis 2007 {published data only}
    1. Willis BC, Wortley P. Nurses' attitudes and beliefs about influenza and the influenza vaccine: a summary of focus groups in Alabama and Michigan. American Journal of Infection Control 2007;35(1):20-4. - PubMed
Yonas 2012 {published data only}
    1. Yonas MA, Nowalk MP, Zimmerman RK, Ahmed F, Albert SM. Examining structural and clinical factors associated with implementation of standing orders for adult immunization. Journal for Healthcare Quality: Promoting Excellence in Healthcare 2012;34(3):34-42. - PubMed
Zwar 2007 {published data only}
    1. Zwar N, Hasan I, Harris M, Traynor V. Barriers and facilitators to influenza vaccination among high-risk groups aged less than 65 years – views from general practitioners and practice nurses. Australian & New Zealand Journal of Public Health 2007;31(6):558-61. - PubMed

Additional references

Aguado 2018
    1. Aguado T, Barratt J, Beard JR, Blomberg BB, Chen WH, Hickling J, et al. Report on WHO meeting on immunization in older adults: Geneva, Switzerland, 22-23 March 2017. Vaccine 2018;36(7):921-31. - PMC - PubMed
Ames 2017
    1. Ames HM, Glenton C, Lewin S. Parents' and informal caregivers' views and experiences of communication about routine childhood vaccination: a synthesis of qualitative evidence. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No: CD011787. [DOI: 10.1002/14651858.CD011787.pub2] - DOI - PMC - PubMed
Ames 2019
    1. Ames HM, Glenton C, Lewin S, Tamrat T, Akama E, Leon N. Clients' perceptions and experiences of targeted digital communication accessible via mobile devices for reproductive, maternal, newborn, child, and adolescent health: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2019, Issue 10. Art. No: CD013447. [DOI: 10.1002/14651858.CD013447] - DOI - PMC - PubMed
Bach 2019
    1. Bach AT, Kang AY, Lewis J, Xavioer S, Portillo I, Goad JA. Addressing common barriers in adult immunizations: a review of interventions. Expert Review of Vaccines 2019;18(11):1167-85. - PubMed
Candy 2011
    1. Candy B, King M, Jones L, Oliver S. Using qualitative synthesis to explore heterogeneity of complex interventions. BMC Medical Research Methodology 2011;11:124. - PMC - PubMed
Carlsen 2016
    1. Carlsen B, Glenton C. The swine flu vaccine, public attitudes, and researcher interpretations: a systematic review of qualitative research. BMC Health Services Research 2016;16:203. [DOI: 10.1186/s12913-016-1466-7] - DOI - PMC - PubMed
CASP 2018
    1. Critical Appraisal Skills Programme (CASP). CASP Qualitative Checklist. casp-uk.net/casp-tools-checklists/ (accessed 4 June 2020).
Cassini 2018
    1. Cassini A, Colzani E, Pini A, Mangen M, Plass D, McDonald SA, et al. Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013. Eurosurveillance 2018;23(16):17-00454. - PMC - PubMed
Cavaleri 2021
    1. Cavaleri M, Enzmann H, Straus S, Cooke E. The European Medicines Agency's EU conditional marketing authorisations for COVID-19 vaccines. Lancet 2021;397(10272):355-7. [DOI: 10.1016/S0140-6736(21)00085-4] - DOI - PMC - PubMed
Charles 1999
    1. Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Social Science & Medicine 1999;49(5):651-61. [DOI: 10.1016/s0277-9536(99)00145-8] - DOI - PubMed
Demicheli 2018
    1. Demicheli V, Jefferson T, Di Pietrantonj C, Ferroni E, Thorning S, Thomas RE, et al. Vaccines for preventing influenza in the elderly. Cochrane Database of Systematic Reviews 2018, Issue 2. Art. No: CD004876. [DOI: 10.1002/14651858.CD004876.pub4] - DOI - PMC - PubMed
Doherty 2018
    1. Doherty TM, Connolly MP, Del Giudice G, Flamaing J, Goronzy JJ, Grubeck-Loebenstein B, et al. Vaccination programs for older adults in an era of demographic change. European Geriatric Medicine 2018;9(3):289-300. - PMC - PubMed
Drieskens 2020
    1. Drieskens S, Charafeddine R, Demarest S, Gisle L, Tafforeau J, Van der Heyden J. Health Interview Survey, Belgium, 1997 – 2001 – 2004 – 2008 – 2013: Health Interview Survey Interactive Analysis. hisia.wiv-isp.be/ (accessed 25 February 2020).
ECDC 2020
    1. European Centre for Disease Prevention and Control (ECDC). Vaccine schedules in all countries of the European Union, 2020. vaccine-schedule.ecdc.europa.eu/ (accessed 25 February 2020).
Eilers 2014
    1. Eilers R, Krabbe PF, Melker HE. Factors affecting the uptake of vaccination by the elderly in Western society. Preventive Medicine 2014;69:224-34. - PubMed
EPOC 2019
    1. Cochrane Effective Practice and Organisation of Care (EPOC). EPOC Qualitative Evidence Syntheses guidance on when to sample and how to develop a purposive sampling frame, 2019. epoc.cochrane.org/resources/epoc-resources-reviewauthors (accessed prior to 14 June 2021).
Freeman 2010
    1. Freeman G, Hughes J. Continuity of Care and the Patient Experience. London (UK): The King's Fund, 2010.
Gagliardi 2019
    1. Gagliardi AM, Andriolo BN, Torloni MR, Soares BG, Oliveira Gomes J, Andriolo RB, et al. Vaccines for preventing herpes zoster in older adults. Cochrane Database of Systematic Reviews 2019, Issue 11. Art. No: CD008858. [DOI: 10.1002/14651858.CD008858.pub4] - DOI - PMC - PubMed
Glenton 2020a
    1. Glenton C, Bohren MA, Downe S, Paulsen EJ, Lewin S, on behalf of Effective Practice and Organisation of Care (EPOC). EPOC Qualitative Evidence Synthesis: protocol and review template. Version 1.1. epoc.cochrane.org/epoc-specific-resources-review-authors) (accessed prior to 14 June 2021).
Glenton 2021
    1. Glenton C, Carlsen B, Wennekes MD, Winje BA, Eilers R, Hoffmann TC, Lewin S, on behalf of the VITAL consortium. Using qualitative research to develop an elaboration of the TIDieR checklist for interventions to enhance vaccination communication: short report (submitted for publication). - PMC - PubMed
Hill 2011
    1. Hill S. The Knowledgeable Patient: Communication and Participation in Health. Chichester (UK): Wiley, 2011.
Hoffmann 2014
    1. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: Template for Intervention Description and Replication (TIDieR) checklist and guide. BMJ 2014;348:g1687. - PubMed
Houghton 2020
    1. Houghton C, Meskell P, Delaney H, Smalle M, Glenton C, Booth A, et al. Barriers and facilitators to healthcare workers' adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No: CD013582. [DOI: 10.1002/14651858.CD013582] - DOI - PMC - PubMed
Jain 2017
    1. Jain A, Hoek AJ, Boccia D, Thomas SL. Lower vaccine uptake amongst older individuals living alone: A systematic review and meta-analysis of social determinants of vaccine uptake. Vaccine 2017;35:2315-28. - PubMed
Kan 2018
    1. Kan T, Zhang J. Factors influencing seasonal influenza vaccination behaviour among elderly people: a systematic review. Public Health 2018;156:67-78. - PMC - PubMed
Kanitz 2012
    1. Kanitz EE, Wu LA, Giambi C, Strikas RA, Levy-Bruhl D, Stefanoff P, et al. Variation in adult vaccination policies across Europe: an overview from VENICE network on vaccine recommendations, funding and coverage. Vaccine 2012;30(35):5222-8. - PubMed
Karimi‐Shahanjarini 2019
    1. Karimi-Shahanjarini A, Shakibazadeh E, Rashidian A, Hajimiri K, Glenton C, Noyes J, et al. Barriers and facilitators to the implementation of doctor-nurse substitution strategies in primary care: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2019, Issue 4. Art. No: CD010412. [DOI: 10.1002/14651858.CD010412.pub2] - DOI - PMC - PubMed
Kaufman 2017
    1. Kaufman J, Ames H, Bosch-Capblanch X, Cartier Y, Cliff J, Glenton C, et al. The comprehensive 'Communicate to Vaccinate' taxonomy of communication interventions for childhood vaccination in routine and campaign contexts. BMC Public Health 2017;17(1):423. - PMC - PubMed
Légaré 2008
    1. Légaré F, Ratté S, Gravel K, Graham ID. Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals' perceptions. Patient Education and Counseling 2008;73(3):526-5. [DOI: 10.1016/j.pec.2008.07.018] - DOI - PubMed
Lewin 2011
    1. Lewin S, Hill S, Abdullahi L, Bensaude de Castro Freire S, Bosch-Capblanch X, Glenton C, et al. 'Communicate to vaccinate' (COMMVAC). Building evidence for improving communication about childhood vaccinations in low- and middle-income countries: protocol for a programme of research. Implementation Science 2011;6(125):1-7. - PMC - PubMed
Lewin 2018a
    1. Lewin S, Booth A, Glenton C, Munthe-Kaas H, Rashidian A, Wainwright M, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series. Implementation Science 2018;13(Suppl 1)(2):1-10. - PMC - PubMed
Lewin 2018b
    1. Lewin S, Bohren M, Rashidian A, Munthe-Kaas H, Glenton C, Colvin CJ, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 2: how to make an overall CERQual assessment of confidence and create a Summary of Qualitative Findings table. Implementation Science 2018;13(Suppl 1)(10):11-23. - PMC - PubMed
Lorenc 2017
    1. Lorenc T, Marshall D, Wright K, Sutcliffe K, Sowden A. Seasonal influenza vaccination of healthcare workers: systematic review of qualitative evidence. BMC Health Services Research 2017;17(1):732. - PMC - PubMed
Montecino‐Rodriguez 2013
    1. Montecino-Rodriguez E, Berent-Maoz B, Dorshkind K. Causes, consequences, and reversal of immune system aging. Journal of Clinical Investigation 2013;123(3):958-65. - PMC - PubMed
Munabi‐Babigumira 2017
    1. Munabi-Babigumira S, Glenton C, Lewin S, Fretheim A, Nabudere H. Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2017, Issue 11. Art. No: CD011558. [DOI: 10.1002/14651858.CD011558.pub2] - DOI - PMC - PubMed
Munthe‐Kaas 2020
    1. Munthe-Kaas H, Nokleby H, Lewin S, Glenton C. The TRANSFER approach for assessing the transferability of systematic review findings. BMC Medical Research Methodology 2020;20(1):11. - PMC - PubMed
Nagata 2013
    1. Nagata JM, Hernández-Ramos I, Kurup AS, Albrecht D, Vivas-Torrealba C, Franco-Paredes C. Social determinants of health and seasonal influenza vaccination in adults ≥65 years: a systematic review of qualitative and quantitative data. BMC Public Health 2013;13:388. - PMC - PubMed
NIPH 2021
    1. NIPH. Toolbox for equitable vaccination delivery [Verktøykasse for et likeverdig vaksinasjonstilbud]. www.fhi.no/nettpub/vaksinasjonsveilederen-for-helsepersonell/vaksinasjon... (accessed prior to 14 June 2021).
Noyes 2018
    1. Noyes J, Booth A, Flemming K, Garside R, Harden A, Lewin S, et al. Cochrane Qualitative and Implementation Methods Group guidance series – paper 3: methods for assessing methodological limitations, data extraction and synthesis, and confidence in synthesized qualitative findings. Journal of Clinical Epidemiology 2018;97:49-58. - PubMed
OECD 2019
    1. Organisation for Economic Cooperation and Development. Influenza vaccination rates. data.oecd.org/healthcare/influenza-vaccination-rates.htm (accessed 25 February 2020).
Ortiz 2016
    1. Ortiz JR, Perut M, Dumolard L, Wijesinghe PR, Jorgensen P, Ropero AM, et al. A global review of national influenza immunization policies: analysis of the 2014 WHO/UNICEF Joint Reporting Form on immunization. Vaccine 2016;34(45):5400-5. - PMC - PubMed
Rimal 2009
    1. Rimal RN, Lapinskib MK. Why health communication is important in public health. Bulletin of the World Health Organization 2009;87:247-8. - PMC - PubMed
Rolfe 2014
    1. Rolfe A, Cash-Gibson L, Car J, Sheikh A, McKinstry B. Interventions for improving patients' trust in doctors and groups of doctors. Cochrane Database of Systematic Reviews 2014, Issue 3. Art. No: CD004134. [DOI: 10.1002/14651858.CD004134.pub3] - DOI - PMC - PubMed
Ruben 2016
    1. Ruben BD. Communication theory and health communication practice: the more things change, the more they stay the same. Health Communication 2016;31:1-11. - PubMed
Ruben 2017
    1. Ruben BD, Gigliotti RA. Communication: sine qua non of organizational leadership theory and practice. International Journal of Business Communication 2017;54(1):12-30.
Rusli 2018
    1. Rusli KD, Bryar R. Maximising influenza vaccination awareness and uptake among older adults in Singapore. British Journal of Community Nursing 2018;23(6):244-9. - PubMed
Stapleton 2002
    1. Stapleton H, Kirkham M, Thomas G. Qualitative study of evidence based leaflets in maternity care. BMJ 2002;324(7338):639. [DOI: 10.1136/bmj.324.7338.639] - DOI - PMC - PubMed
Thomas 2008
    1. Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology 2008;8(45):1-10. - PMC - PubMed
Thomas 2018
    1. Thomas RE, Lorenzetti DL. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database of Systematic Reviews 2018, Issue 5. Art. No: CD005188. [DOI: 10.1002/14651858.CD005188.pub4] - DOI - PMC - PubMed
UN 2019
    1. United Nations. World population prospects 2019: highlights (ST/ESA/SER.A/423). United Nations, Department of Economic and Social Affairs, Population Division 2019.
Ward 2008
    1. Ward L, Draper J. A review of the factors involved in older people's decision making with regard to influenza vaccination: a literature review. Journal of Clinical Nursing 2008;17(1):5-16. - PubMed
Wennekes 2021
    1. Wennekes MD, Almási T, Eilers R, Mezei F, Petykó Z, Timen A, et al. Characteristics of effective educational interventions targeting healthcare workers to improve advising about vaccinations for older adults: a systematic review as part of the VITAL-project (Vaccines and InfecTious diseases in the Ageing popuLation). Unpublished.
Wetzels 2004
    1. Wetzels R, Geest TA, Wensing M, Ferreira PL, Grol R, Baker R. GPs' views on involvement of older patients: an European qualitative study. Patient Education and Counseling 2004;53(2):183-8. [DOI: 10.1016/S0738-3991(03)00145-9] - DOI - PubMed
WHO 2003
    1. World Health Organization. Prevention and control of influenza pandemics and annual epidemics, World Health Assembly, 56. apps.who.int/iris/handle/10665/78320 (accessed 14 July 2020).
WHO 2015
    1. World Health Organization. World Report on Ageing and Health. Geneva: World Health Organization, 2015.
WHO 2020
    1. World Health Organization. WHO SAGE values framework for the allocation and prioritization of COVID-19 vaccination. apps.who.int/iris/handle/10665/334299 (accessed prior to 14 June 2021).
WHO 2021
    1. WHO. Interim recommendations for use of the Moderna mRNA-1273 vaccine against COVID-19: interim guidance. apps.who.int/iris/handle/10665/338862 (accessed prior to 14 June 2021).
Williams 2017
    1. Williams WW, Lu P, O'Halloran A, Kim DK, Grohskopf LA, Pilishvili T, et al. Surveillance of vaccination coverage among adult populations – United States, 2015. www.cdc.gov/mmwr/volumes/66/ss/ss6611a1.htm (accessed 14 July 2020). - PMC - PubMed
Winje 2019
    1. Winje BA, Berild J, Vestrheim DF, Denison E, Lepp T, Roth A, et al. Efficacy and effectiveness of pneumococcal vaccination in elderly – an update of the literature. The Norwegian Institute of Public Health, Division of Infection Control and Environmental Health, Department of Infection Control and Vaccines 2019.

References to other published versions of this review

Glenton 2020b
    1. Glenton C, Winje BA, Carlsen B, Eilers R, Wennekes MD, Lewin S. Healthcare workers' perceptions and experiences of communicating with people over 50 about vaccination: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No: CD013706. [DOI: 10.1002/14651858.CD013706] - DOI - PMC - PubMed

Publication types