Effect of vaccine education intervention on vaccine uptake and vaccine knowledge among older adults: A systematic review with meta-analysis

Educational intervention is one approach for providing vaccine knowledge and encouraging vaccine uptake. However, up till now, no systematic review reporting the effectiveness of vaccine educational intervention on vaccine uptake and/or knowledge enhancement for disease preventeable by the vaccine of interest, compared to conventional/standard or no intervention, for older adults aged 60 or above was found.

Six databases, including PubMed, OVID, CINAHL, Web of Science, the Cochrane Library, and the British Nursing Index, were searched. Vaccine educational interventions in this study were interventions that encourage vaccine uptake and/or provide knowledge enhancement on diseases prevented by the vaccine. Conventional/standard or no intervention refers to vaccine educational intervention that existed prior to the commencement of the intervention or no vaccine educational intervention was performed at all. All included studies were randomized control trials. The appraisal was performed with the Cochrane Risk of Bias Tool Version 1 (RoB 1). Meta-analysis was performed with RevMan Web. Ten studies were included in the meta-analysis, with a sample size of 419,523. This review demonstrated that vaccine educational intervention improves vaccine uptake (Relative Risk: 1.19, p = 0.008, 95 % confidence interval: 1.05–1.35). Furthermore, interactive vaccine educational intervention had a statistically significant effect on improving vaccine uptake among older adults (Relative Risk = 1.33, 95 % confidence interval: 1.08–1.62, p = 0.006). Neither continuous nor conducted once only intervention were found to have statistically significant improvement in vaccine uptake in the subgroup analysis. Vaccine educational interventions were found to have statistically significant effects on vaccine knowledge enhancement (Mean Difference: 0.42, 95 % confidence interval: 0.11–0.74, p = 0.008). The findings demonstrate that educational interventions significantly encourage vaccine uptake and knowledge enhancement in older adults. However, the limited amount of included literature and the high heterogeneity observed may limit the generalizability of the findings of this study. Further RCTs are recommended to bring more assertive results.