Cochrane for Clinicians

Putting Evidence into Practice

Interventions Aimed at Increasing Childhood Vaccination Rates


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Am Fam Physician. 2015 Nov 1;92(9):775-776.

Clinical Question

Are interventions to inform and educate about childhood vaccinations effective?

Evidence-Based Answer

Community discussions, community meetings, and information campaigns may increase immunization uptake in areas with only moderate vaccine use. There is no clear evidence to guide face-to-face educational interventions, and the impact of face-to-face interventions is uncertain in areas where immunization use is already relatively high.

Practice Pointers

A recent decision analysis suggested that in the United States, routine administration of the nine immunizations recommended in the 2009 childhood immunization schedule prevents approximately 42,000 early deaths and 20 million cases of disease.1 However, vaccine coverage of the general population is less than optimal because of missed opportunities and misconceptions by parents and clinicians.2 A previous systematic review found evidence that multicomponent interventions, which include education, may be effective at improving vaccination coverage.3 The Communicate to Vaccinate project developed two Cochrane reviews on the effectiveness of interventions to educate parents and communities about childhood vaccinations. Although Communicate to Vaccinate focused on low-

Author disclosure: No relevant financial affiliations.

The practice recommendations in this activity are available at and


Saeterdal I, Lewin S, Austvoll-Dahlgren A, Glenton C, Munabi-Babigumira S. Interventions aimed at communities to inform and/or educate about early childhood vaccination. Cochrane Database Syst Rev. 2014;(11):CD010232; and Kaufman J, Synnot A, Ryan R, et al. Face to face interventions for informing or educating parents about early childhood vaccination. Cochrane Database Syst Rev. 2013;(5):CD010038.


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1. Zhou F, Shefer A, Wenger J, et al. Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics. 2014;133(4):577–585....

2. Epling JW, Savoy ML, Temte JL, Schoof BK, Campos-Outcalt D. When vaccine misconceptions jeopardize public health. J Fam Pract. 2014;63(12):E1–E7.

3. Briss PA, Rodewald LE, Hinman AR, et al. Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. The Task Force on Community Preventive Services. Am J Prev Med. 2000;18(1 suppl):97–140.

4. Mills E, Jadad AR, Ross C, Wilson K. Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination. J Clin Epidemiol. 2005;58(11):1081–1088.

5. Nordin J, Anderson R, Anderson R, et al. Immunizations. Bloomington, Minn.: Institute for Clinical Systems Improvement; 2012:1–81.

These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, Assistant Medical Editor.

A collection of Cochrane for Clinicians published in AFP is available at


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