{"title":"Effectiveness of interventions to improve vaccine efficacy: a systematic review and meta-analysis.","authors":"Aviraj K S, Apoorva Wasnik, Lalima Gupta, Ayushi Ranjan, Harshini Suresh","doi":"10.1186/s13643-025-02856-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Vaccination is a crucial public health intervention that has significantly reduced the incidence of infectious diseases. Vaccine-related interventions refer to strategies implemented to enhance vaccination uptake, coverage, and effectiveness, like modes of delivery, types or dosages. Despite extensive research on vaccine efficacy, a comprehensive analysis of the variability in vaccine effectiveness across different interventions, settings, and populations is limited. This study aims to systematically review and meta-analyze the impact of various Vaccine-Related Interventions (VRIs).</p><p><strong>Methods: </strong>This review included 139 randomized controlled trials, cohort, and case-control studies evaluating VRIs from January 2015 to December 2023. The risk of bias was assessed using the ROB-2 and ROBINS-E tools. Statistical analyses were conducted to evaluate overall effect sizes, infection rates, and heterogeneity and subgroup analysis.</p><p><strong>Results: </strong>Of the 139 studies reviewed, 97 were included in the meta-analysis, comprising approximately 1.4 million participants. Populations across various settings were analyzed, with median vaccinated population sizes for the 1st dose (4598, IQR = 15,749), 2nd dose (6214, IQR = 13,817), and 3rd dose (3508, IQR = 5546). The overall total vaccinated population had a median of 4370 and an IQR of 16,475. The interventions showed a significant positive effect on vaccine efficacy, with an estimated effect size of 0.6432 (95% CI 0.4049 to 0.8815). Heterogeneity was negligible, with Tau<sup>2</sup> = 0, I<sup>2</sup> = 0.00%, and H<sup>2</sup> = 1.00. The Galbraith plot suggested minimal variability. The study utilized ROB-2 and ROBINS-E tools to evaluate bias, with Egger's test (t = - 0.9941, p = 0.3227) confirming no significant publication bias. The funnel plot indicated minimal bias in the included studies.</p><p><strong>Conclusion: </strong>The study supports the effectiveness of vaccine-related interventions in enhancing vaccine efficacy. The negligible heterogeneity and consistent effect sizes across diverse populations and settings provide a robust basis for implementing public health strategies aimed at improving vaccination outcomes.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024543608.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"105"},"PeriodicalIF":6.3000,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063308/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Systematic Reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13643-025-02856-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Vaccination is a crucial public health intervention that has significantly reduced the incidence of infectious diseases. Vaccine-related interventions refer to strategies implemented to enhance vaccination uptake, coverage, and effectiveness, like modes of delivery, types or dosages. Despite extensive research on vaccine efficacy, a comprehensive analysis of the variability in vaccine effectiveness across different interventions, settings, and populations is limited. This study aims to systematically review and meta-analyze the impact of various Vaccine-Related Interventions (VRIs).
Methods: This review included 139 randomized controlled trials, cohort, and case-control studies evaluating VRIs from January 2015 to December 2023. The risk of bias was assessed using the ROB-2 and ROBINS-E tools. Statistical analyses were conducted to evaluate overall effect sizes, infection rates, and heterogeneity and subgroup analysis.
Results: Of the 139 studies reviewed, 97 were included in the meta-analysis, comprising approximately 1.4 million participants. Populations across various settings were analyzed, with median vaccinated population sizes for the 1st dose (4598, IQR = 15,749), 2nd dose (6214, IQR = 13,817), and 3rd dose (3508, IQR = 5546). The overall total vaccinated population had a median of 4370 and an IQR of 16,475. The interventions showed a significant positive effect on vaccine efficacy, with an estimated effect size of 0.6432 (95% CI 0.4049 to 0.8815). Heterogeneity was negligible, with Tau2 = 0, I2 = 0.00%, and H2 = 1.00. The Galbraith plot suggested minimal variability. The study utilized ROB-2 and ROBINS-E tools to evaluate bias, with Egger's test (t = - 0.9941, p = 0.3227) confirming no significant publication bias. The funnel plot indicated minimal bias in the included studies.
Conclusion: The study supports the effectiveness of vaccine-related interventions in enhancing vaccine efficacy. The negligible heterogeneity and consistent effect sizes across diverse populations and settings provide a robust basis for implementing public health strategies aimed at improving vaccination outcomes.
期刊介绍：
Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.
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