Systematic review and meta-analysis of interventions to increase the uptake of vaccines recommended during pregnancy

Abstract Although immunization during pregnancy can protect mothers and their infants from vaccine-preventable morbidity and mortality, vaccination rates are often poor. We systematically reviewed the literature from inception to July 4, 2023, for randomized and non-randomized quasi-experimental stu...

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Main Authors: Annette K. Regan, Honorine Uwimana, Stacey L. Rowe, Elizabeth Jitka Olsanska, Brianna Agnew, Eliana Castillo, Alice Fiddian-Green, Michelle L. Giles
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:npj Vaccines
Online Access:https://doi.org/10.1038/s41541-025-01120-1
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author Annette K. Regan
Honorine Uwimana
Stacey L. Rowe
Elizabeth Jitka Olsanska
Brianna Agnew
Eliana Castillo
Alice Fiddian-Green
Michelle L. Giles
author_facet Annette K. Regan
Honorine Uwimana
Stacey L. Rowe
Elizabeth Jitka Olsanska
Brianna Agnew
Eliana Castillo
Alice Fiddian-Green
Michelle L. Giles
author_sort Annette K. Regan
collection DOAJ
description Abstract Although immunization during pregnancy can protect mothers and their infants from vaccine-preventable morbidity and mortality, vaccination rates are often poor. We systematically reviewed the literature from inception to July 4, 2023, for randomized and non-randomized quasi-experimental studies estimating the effects of interventions to increase vaccination during pregnancy. Of 9331 studies screened, 36 met inclusion criteria, including 18 demand-side interventions, 11 supply-side interventions, and seven multi-level (demand and supply-side) interventions. Demand-side interventions commonly addressed patient education, showing modest improvement (pooled RR 1.18; 95% CI: 1.04, 1.33; I 2 = 63.1%, low certainty). Supply-side interventions commonly implemented Assessment-Feedback-Incentive-eXchange interventions with little improvement (pooled RR 1.13; 95% CI: 0.96, 1.33; I 2 = 94.0%, low certainty). Multi-level interventions were modestly effective in increasing vaccination (pooled RR 1.62; 95% CI: 1.09, 2.42; I 2 = 97%, very low certainty). Interventions identified in the literature mostly resulted in low to moderate increases in vaccination with likely high heterogeneity and low to very low certainty in the findings.
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spelling doaj-art-dcdd0be7d24941bc91abe6d04dbfe64d2025-08-20T02:17:57ZengNature Portfolionpj Vaccines2059-01052025-04-0110111710.1038/s41541-025-01120-1Systematic review and meta-analysis of interventions to increase the uptake of vaccines recommended during pregnancyAnnette K. Regan0Honorine Uwimana1Stacey L. Rowe2Elizabeth Jitka Olsanska3Brianna Agnew4Eliana Castillo5Alice Fiddian-Green6Michelle L. Giles7Department of Research & Evaluation, Kaiser Permanente Southern CaliforniaSchool of Nursing and Health Professions, University of San FranciscoSchool of Nursing and Health Professions, University of San FranciscoCollege of Arts & Sciences, University of San FranciscoSchool of Nursing and Health Professions, University of San FranciscoDepartments of Medicine and Obstetrics & Gynaecology, University of CalgarySchool of Nursing and Health Professions, University of San FranciscoDepartment of Obstetrics and Gynecology, Monash UniversityAbstract Although immunization during pregnancy can protect mothers and their infants from vaccine-preventable morbidity and mortality, vaccination rates are often poor. We systematically reviewed the literature from inception to July 4, 2023, for randomized and non-randomized quasi-experimental studies estimating the effects of interventions to increase vaccination during pregnancy. Of 9331 studies screened, 36 met inclusion criteria, including 18 demand-side interventions, 11 supply-side interventions, and seven multi-level (demand and supply-side) interventions. Demand-side interventions commonly addressed patient education, showing modest improvement (pooled RR 1.18; 95% CI: 1.04, 1.33; I 2 = 63.1%, low certainty). Supply-side interventions commonly implemented Assessment-Feedback-Incentive-eXchange interventions with little improvement (pooled RR 1.13; 95% CI: 0.96, 1.33; I 2 = 94.0%, low certainty). Multi-level interventions were modestly effective in increasing vaccination (pooled RR 1.62; 95% CI: 1.09, 2.42; I 2 = 97%, very low certainty). Interventions identified in the literature mostly resulted in low to moderate increases in vaccination with likely high heterogeneity and low to very low certainty in the findings.https://doi.org/10.1038/s41541-025-01120-1
spellingShingle Annette K. Regan
Honorine Uwimana
Stacey L. Rowe
Elizabeth Jitka Olsanska
Brianna Agnew
Eliana Castillo
Alice Fiddian-Green
Michelle L. Giles
Systematic review and meta-analysis of interventions to increase the uptake of vaccines recommended during pregnancy
npj Vaccines
title Systematic review and meta-analysis of interventions to increase the uptake of vaccines recommended during pregnancy
title_full Systematic review and meta-analysis of interventions to increase the uptake of vaccines recommended during pregnancy
title_fullStr Systematic review and meta-analysis of interventions to increase the uptake of vaccines recommended during pregnancy
title_full_unstemmed Systematic review and meta-analysis of interventions to increase the uptake of vaccines recommended during pregnancy
title_short Systematic review and meta-analysis of interventions to increase the uptake of vaccines recommended during pregnancy
title_sort systematic review and meta analysis of interventions to increase the uptake of vaccines recommended during pregnancy
url https://doi.org/10.1038/s41541-025-01120-1
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