Communication-based interventions to increase COVID-19 vaccine willingness and uptake: a systematic review with meta-analysis

Objective This systematic review investigates the effectiveness of different communication strategies to increase COVID-19 vaccine uptake and willingness.Design Systematic review and meta-analysis of randomised controlled trials (RCTs), following recommendations from the Cochrane Handbook and report...

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Main Authors: Jessica Kaufman, Nicole Skoetz, Ina Monsef, Claire Iannizzi, Marike Andreas, Emma Bohndorf, Caroline Hirsch, Ana-Mihaela Zorger, Janine Brinkmann-Paulukat, Brigitte Bormann, Tina Lischetzki, Julia Neufeind, Nora Schmid-Küpke, Sebastian Thole, Karina Worbes
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/5/e072942.full
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author Jessica Kaufman
Nicole Skoetz
Ina Monsef
Claire Iannizzi
Marike Andreas
Emma Bohndorf
Caroline Hirsch
Ana-Mihaela Zorger
Janine Brinkmann-Paulukat
Brigitte Bormann
Tina Lischetzki
Julia Neufeind
Nora Schmid-Küpke
Sebastian Thole
Karina Worbes
author_facet Jessica Kaufman
Nicole Skoetz
Ina Monsef
Claire Iannizzi
Marike Andreas
Emma Bohndorf
Caroline Hirsch
Ana-Mihaela Zorger
Janine Brinkmann-Paulukat
Brigitte Bormann
Tina Lischetzki
Julia Neufeind
Nora Schmid-Küpke
Sebastian Thole
Karina Worbes
author_sort Jessica Kaufman
collection DOAJ
description Objective This systematic review investigates the effectiveness of different communication strategies to increase COVID-19 vaccine uptake and willingness.Design Systematic review and meta-analysis of randomised controlled trials (RCTs), following recommendations from the Cochrane Handbook and reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.Data sources We searched the following databases until 27 July 2022: Cochrane COVID-19 Study Register, PsycINFO, CINAHL, Web of Science Core Collection and WHO COVID-19 Global literature.Eligibility criteria for study selection We included RCTs investigating, any population, communication-based interventions to increase COVID-19 vaccine uptake and comparing these with no intervention (with or without placebo), another communication strategy or another type of intervention.Methods Screening, data extraction and bias assessment, using the Cochrane ROB 1.0 tool, were conducted by two authors independently. We performed meta-analyses if studies were homogeneous using the Review Manager (RevMan 5) software, synthesised the remaining results narratively and assessed the certainty in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.Results We identified 49 studies reporting on the predefined four categories of communication interventions. Evidence from our meta-analyses shows that COVID-19 vaccine uptake may increase when education and information strategies are applied (risk ratio (RR) 1.23, 95% CI 1.17 to 1.28; high-certainty evidence) or social norms are communicated (RR 1.28, 95% CI 1.23 to 1.33; high-certainty evidence) compared with no intervention. The different communication strategies mostly have little to no impact on vaccine intention; however, there may be a slight increase in vaccine confidence when gain framing is applied compared with no intervention.Conclusion Overall, we found that education and information-based interventions or social norm-framing strategies are most effective compared with no intervention given. Our findings show that some of the investigated communication strategies might influence policy decision-making, and our results could be useful for future pandemics as well.PROSPERO registration number PROSPERO (CRD42021296618).
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spelling doaj-art-e522ff95f8ba49b6b85e2b47dce1add52025-08-20T01:51:58ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2023-072942Communication-based interventions to increase COVID-19 vaccine willingness and uptake: a systematic review with meta-analysisJessica Kaufman0Nicole Skoetz1Ina Monsef2Claire Iannizzi3Marike Andreas4Emma Bohndorf5Caroline Hirsch6Ana-Mihaela Zorger7Janine Brinkmann-Paulukat8Brigitte Bormann9Tina Lischetzki10Julia Neufeind11Nora Schmid-Küpke12Sebastian Thole13Karina Worbes14Murdoch Children’s Research Institute, Parkville, Victoria, AustraliaInstitute of Public Health, University of Cologne, Cologne, GermanyInstitute of Public Health, University of Cologne, Cologne, GermanyInstitute of Public Health, University of Cologne, Cologne, GermanyEvidence-based Medicine Department I of Internal Medicine, University of Cologne, Cologne, GermanyEvidence-based Medicine Department I of Internal Medicine, University of Cologne, Cologne, GermanyInstitute of Public Health, University of Cologne, Cologne, GermanyInstitute of Public Health, University of Cologne, Cologne, GermanyDivision Infection Prevention NRW Centre for Health, Bochum, GermanyDivision Health Data, Healthcare Structures, NRW Centre for Health, Bochum, GermanyEvidence-based Medicine Department I of Internal Medicine, University of Cologne, Cologne, GermanyRobert Koch Institute, Berlin, GermanyRobert Koch Institute, Berlin, GermanyDivision Infection Prevention NRW Centre for Health, Bochum, GermanyInstitute of Public Health, University of Cologne, Cologne, GermanyObjective This systematic review investigates the effectiveness of different communication strategies to increase COVID-19 vaccine uptake and willingness.Design Systematic review and meta-analysis of randomised controlled trials (RCTs), following recommendations from the Cochrane Handbook and reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.Data sources We searched the following databases until 27 July 2022: Cochrane COVID-19 Study Register, PsycINFO, CINAHL, Web of Science Core Collection and WHO COVID-19 Global literature.Eligibility criteria for study selection We included RCTs investigating, any population, communication-based interventions to increase COVID-19 vaccine uptake and comparing these with no intervention (with or without placebo), another communication strategy or another type of intervention.Methods Screening, data extraction and bias assessment, using the Cochrane ROB 1.0 tool, were conducted by two authors independently. We performed meta-analyses if studies were homogeneous using the Review Manager (RevMan 5) software, synthesised the remaining results narratively and assessed the certainty in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.Results We identified 49 studies reporting on the predefined four categories of communication interventions. Evidence from our meta-analyses shows that COVID-19 vaccine uptake may increase when education and information strategies are applied (risk ratio (RR) 1.23, 95% CI 1.17 to 1.28; high-certainty evidence) or social norms are communicated (RR 1.28, 95% CI 1.23 to 1.33; high-certainty evidence) compared with no intervention. The different communication strategies mostly have little to no impact on vaccine intention; however, there may be a slight increase in vaccine confidence when gain framing is applied compared with no intervention.Conclusion Overall, we found that education and information-based interventions or social norm-framing strategies are most effective compared with no intervention given. Our findings show that some of the investigated communication strategies might influence policy decision-making, and our results could be useful for future pandemics as well.PROSPERO registration number PROSPERO (CRD42021296618).https://bmjopen.bmj.com/content/15/5/e072942.full
spellingShingle Jessica Kaufman
Nicole Skoetz
Ina Monsef
Claire Iannizzi
Marike Andreas
Emma Bohndorf
Caroline Hirsch
Ana-Mihaela Zorger
Janine Brinkmann-Paulukat
Brigitte Bormann
Tina Lischetzki
Julia Neufeind
Nora Schmid-Küpke
Sebastian Thole
Karina Worbes
Communication-based interventions to increase COVID-19 vaccine willingness and uptake: a systematic review with meta-analysis
BMJ Open
title Communication-based interventions to increase COVID-19 vaccine willingness and uptake: a systematic review with meta-analysis
title_full Communication-based interventions to increase COVID-19 vaccine willingness and uptake: a systematic review with meta-analysis
title_fullStr Communication-based interventions to increase COVID-19 vaccine willingness and uptake: a systematic review with meta-analysis
title_full_unstemmed Communication-based interventions to increase COVID-19 vaccine willingness and uptake: a systematic review with meta-analysis
title_short Communication-based interventions to increase COVID-19 vaccine willingness and uptake: a systematic review with meta-analysis
title_sort communication based interventions to increase covid 19 vaccine willingness and uptake a systematic review with meta analysis
url https://bmjopen.bmj.com/content/15/5/e072942.full
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