Successful Interventions to Improve Pediatric Vaccine Uptake in Hesitant Cohorts: A Scoping Review

Abstract

Vaccine hesitancy is a multi-faceted topic that encompasses many different etiologies and solutions. There remains limited literature regarding effective interventions to target these hesitant cohorts. The objective of our paper was to review existing publications that quantitatively measure if tested interventions resulted in an increase in pediatric vaccine uptake within populations that have been evaluated for vaccine hesitancy. Articles were obtained by performing a database search of PubMed, Embase, and Cochrane databases, as well as through hand-searching. Eligible studies included those published in or after 2013, conducted in the United States on pediatric participants eighteen years or younger, and measured quantitatively the success of an intervention. Eight reviewers screened titles, abstracts, and full texts for inclusion. Rayyan facilitated an organized screening process. Data was hand-extracted and collated into charts to identify trends from the seven final articles. Seven articles describing successful interventions that addressed parental vaccine hesitancy and increased pediatric vaccination rates were analyzed. The most prevalent theme among the interventions was healthcare provider communication (71%), followed by parent education (57%), multi-level interventions (57%), standardization of the vaccination process (43%), and healthcare provider education (23%). There were limitations to this scoping review. While vaccine hesitancy was surveyed pre-intervention in each study, those individuals identified as hesitant were not isolated for the target intervention, apart from one article. Additionally, there were different study outcome measures, which made the statistics not directly comparable. Nonetheless, this scoping review identified recurrent evidence-based themes to increase vaccine uptake in hesitant pediatric populations. These interventions should be implemented in medical education and clinical practices to improve pediatric vaccine coverage.

Keywords: childhood immunization; parent education; parental attitudes; patient provider communication; pediatric vaccines; undergraduate medical education; vaccine hesitancy.

Figure 1. PRISMA Flow Diagram of Study Selection Process

Figure 2. Major Themes

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