Effectiveness of interventions to increase vaccine uptake: component network meta-analysis
Year: 2026
Type: article
Study designs: Systematic Review, Meta-Analysis
Abstract: OBJECTIVES: To identify the effective components of interventions to increase vaccine uptake and to explore variations in effectiveness by population group and in relation to the covid-19 pandemic. DESIGN: Component network meta-analysis. SETTING: Systematic review of randomised controlled trials in high and upper middle income countries. PARTICIPANTS: 237 studies with 570 intervention arms and 4 361 717 participants. INTERVENTIONS: Any intervention targeting vaccine recipients or their caregivers aiming to increase demand for, or access to, vaccinations on the UK immunisation schedule. Key content and delivery features of interventions were identified using a bespoke coding framework co-developed with stakeholders. MAIN OUTCOME MEASURES: The outcome of interest was vaccine uptake. Bayesian component level meta-regression estimated relative effects of intervention components as ratios of odds ratios with 95% credible intervals (CrIs). RESULTS: Of the included studies, 110 were at low risk of bias, 96 had some concerns, and 31 were at high risk. 40% (n=1 744 686) of the participants were male. For children, there was evidence of beneficial effects for payments to cover costs (ratio of odds ratios 3.01, 95% CrI 1.49 to 6.06) and decision aids (2.73, 1.14 to 7.06), and some evidence for extended opportunities (1.37, 0.98 to 1.95) and social factors (1.27, 0.99 to 1.65). For adolescents and young adults, there were beneficial effects for personal delivery formats (2.13, 1.09 to 4.40), delivery by community members alongside healthcare professionals (6.42, 1.94 to 25.62), and social factors (2.62, 1.45 to 5.04), and negative effects for decision aids (0.43, 0.18 to 0.98) and human versus non-human interaction (0.47, 0.21 to 1.02). For adults, beneficial effects were shown for human interaction (1.86, 1.42 to 2.45), extended opportunities (1.63, 1.35 to 2.00), help with appointment scheduling (1.38, 1.06 to 1.78), payments to cover costs (1.47, 1.03 to 2.16), and motivational interviewing (1.79, 1.21 to 2.64), and there was some evidence for financial incentives (1.15, 0.99 to 1.35) and information on vaccine safety and/or efficacy (1.15, 0.99 to 1.32). For adults, evidence also showed a negative effect of non-human interaction versus no interaction (0.72, 0.57 to 0.92). Subgroup analyses showed variation for underserved populations and in relation to the covid-19 pandemic (before 2020 and 2020 onwards). CONCLUSION: Overall, extended opportunities, appointment scheduling help, financial incentives, payments to cover costs, and motivational interviewing were effective content components of interventions to increase vaccine uptake. Effective delivery components overall were human interaction and delivery by community members alongside healthcare professionals. However, effective components varied by age group, for underserved populations, and in analyses investigating the impact of the covid-19 pandemic. These findings have important implications for designing, optimising, and implementing targeted interventions, highlighting which components are effective across different populations and contexts. Consideration of the economic data on interventions should further support resource informed decision making.
Source: BMJ
Institutions: University of Bristol, University Hospitals Bristol and Weston NHS Foundation Trust, NIHR Applied Research Collaboration West, MRC Integrative Epidemiology Unit, London School of Hygiene & Tropical Medicine, Faculty of Public Health, University of the West of England, University of Southampton, UK Health Security Agency
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: hybrid
Funders: London School of Hygiene and Tropical Medicine, Wellcome Trust, University Hospitals Bristol NHS Foundation Trust, National Institute for Health Research Health Protection Research Unit, National Institute for Health and Care Research, Department of Health and Social Care, University of Bristol, Public Health Research Programme, National Institute for Health Research Applied Research Collaboration West
Awards: G138364660, G1608587080, G1645437821, G1653586801, NIHR Senior Investigator Award, G201228873, G2236396740, G231095379, G3248237061, G3501295182, G3527403899, G3999029651, G4879053696, Production of Evidence Syntheses for the Evidence Synthesis Programme, G5261439395, G5308259678, Determining Efficacy and Safety of Drugs Used to Treat Autoimmune Conditions During Pregnancy, G61452808, G6317642042, Vaccination in older adults: understanding how to do it better and knowing when to stop, G7056352423, Determining Efficacy and Safety of Drugs Used to Treat Autoimmune Conditions During Pregnancy, Interventions to increase vaccine uptake: Systematic review and component network meta-analysis to identify the most effective strategies, G99274520
OpenAlex ID: W7154451477