2_SAGE_Appendicies_Background_final

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provider discussions with vaccine-hesitant parents have been published, [17-21] but few have been evaluated.Whereas communication frameworks often suggest discussing vaccines in a participatory and open manner,a 2013 study by Opel, et al. found that more directive, presumptive discussion styles might be more effectiveto improve vaccine acceptance in the middle to upper class vaccine hesitant Seattle population studied . [22] Inaddition, interventions using mass media, including the internet, are challenging to evaluate and are notwell-suited to experimental design; other type of evaluations are subject to various bias due to the manypotential confounding factors which limits the quality of the evidence available.Nevertheless, key principles to optimize the development of strategies to address vaccine hesitancy can beidentified when looking at the literature. To be effective, interventions should be developed using a planningframework, such as the TIP toolkit ( See Section 5), and should be based on a theoretical model. [7] The useof a combination of different interventions (multiple-components) appears to be more effective than singlecomponentintervention. [2, 14, 23] Interventions are most likely to succeed when they are based on empiricaldata and situational assessment – both to have a detailed level of understanding of the vaccine hesitancysituation (susceptible populations, key determinants of vaccination, barriers and enabling conditions, etc.)than to properly evaluate the impact of the intervention. [7, 24] Finally, the development of culturally-tailoredand personalized interventions have shown to be effective to enhance compliance to preventive behaviors,[4, 25-27]including vaccination.77
Table 1.Summary of published literature reviews and meta-analysis on strategies to address vaccine hesitancy (2006 to 2014)Title/ First author/year of publicationIncreasingAppropriateVaccination, TheCommunityGuide [14]Description of the reviewsGeneralPurpose andsettingTo presentsthe results ofsystematicreviews of theeffectiveness,applicability,other effects,economicimpact, andbarriers to useof selectedpopulationbasedinterventionsintended toimprovevaccinationcoverage inHICInclusion /Exclusion criteriaInclusion:Interventionsaddressinguniversallyrecommendedadult, adolescent,or childhoodvaccinationsPrimary studyTake place in HICBe written inEnglishMeet the evidencereview and Guidechapterdevelopmentteam’s definitionof theinterventionsProvideinformation on oneor more outcomesrelated to theanalyticframeworksCompare a groupof persons whohad been exposedto the interventionwith a group whohad not beenMainoutcomemeasureVaccineuptakeNb ofstudiesincludedFrom 2 to240dependingon thetype ofinterventionsQualityassessmentof studiesReportedMain conclusionsInterventions to increase Community Demand for VaccinationsThe Community Preventive Services Task Force recommends:Client or family incentive rewards based on sufficientevidence of effectiveness in increasing vaccination rates inchildren and adults (based on results from six studies thatevaluated incentive awards alone or in combination withadditional interventions).Reminder and recall interventions based on strong evidenceof effectiveness in improving vaccination coverage in childrenand adults, in a range of settings and populations, whenapplied at different levels of scale from individual practicesettings to entire communities, across a range of interventioncharacteristics, when used alone or with additional components(62 studies).Community-based interventions implemented incombination (to enhance access to vaccination services,increase community demand, and reduce missed opportunitiesby vaccination providers) to increase vaccinations in targetedpopulations, on the basis of strong evidence of effectiveness inincreasing vaccination rates (17 studies).Vaccination requirements for child care, school, andcollege attendance based on strong evidence of effectivenessin increasing vaccination rates and in decreasing rates ofvaccine-preventable disease and associated morbidity andmortality, based on findings from 27 studies demonstratingeffectiveness of vaccination requirements: for attendance in avariety of settings; for an array of recommended vaccine; inpopulations ranging in age from early childhood to lateadolescence.There is insufficient evidence to determine the effectiveness of:Client-held Paper Immunization Records (7 studies)78
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APPENDICES TO THEREPORT OF THE SAGE
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vaccine hesitancy in low income cou
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INDIVIDUAL andGROUPINFLUENCESInflue
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Another model reviewed by the Worki
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Appendix for Section 4Appendix A4.1
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epresented mostly low and middle in
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was more hesitant than the younger
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a variable or to a lack of understa
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References[1] World Health Organiza
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Country FVaccine hesitancy is not a
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Figure 1. IMs’ opinions regarding
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DefinitionVaccination confidence is
Page 27 and 28: Of all participating countries, 19%
Page 29 and 30: Countries from all 3 regions provid
Page 31 and 32: Table 5: Income level of countries
Page 33 and 34: variety of determinants of vaccine
Page 35 and 36: Uruguay no no responseVenezuela no
Page 37 and 38: RussianFederationyesQuestioning dur
Page 39 and 40: Question 2:Was this % measured or e
Page 41 and 42: Of those countries which submitted
Page 43 and 44: Indicator 2:Indicator 2 was modifie
Page 45 and 46: Table 4. Top three reasons for vacc
Page 47 and 48: The overall response rate to both i
Page 49 and 50: Czech Republic No 1. The fear of si
Page 51 and 52: Kyrgyzstan Yes В 2013 году в
Page 53 and 54: Table A5.3 .1: Survey questions to
Page 55 and 56: Table A5.3.1: Survey questions to a
Page 57 and 58: Table A5.3.2: Survey questions to a
Page 59 and 60: Appendix A5.4 WHO EUR Tailoring Imm
Page 61 and 62: Objective 2 - Characteristics of ev
Page 63 and 64: Most interventions targeted parents
Page 65 and 66: Table 2. PICO questions proposed by
Page 67 and 68: Dialogue-based interventionsEleven
Page 69 and 70: The impact of information-based tra
Page 71 and 72: Conclusions and implicationsLiterat
Page 73 and 74: Appendix A6A.2 Strategies to addres
Page 75 and 76: change in attitudes).- Most studies
Page 77: Strategies to address vaccine hesit
Page 81 and 82: Title/ First author/year of publica
Page 91 and 92: References1. Williams, S.E., What a
Page 93 and 94: Appendix A6C.1 Vaccine Hesitancy La
Page 95 and 96: ii. Google (Hong Kong)• Used the
Page 97 and 98: Categories Key Actors Areas ofWork/
Page 101 and 102: Categories Key Actors Areas ofActio
Page 107 and 108: This landscape analysis, along with
Page 109 and 110: References for Vaccine Hesitancy La
Page 111: 67 Robert Wood Johnson Foundation.
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