Overview

This database contains a brief overview of 194 systematic reviews on the acceptability and uptake of vaccines for children, young people and adults, published between 2010 and 2020*. It provides the user with information about the broad scope of the reviews, in terms of their overall aims and vaccine and population focus.

Each systematic review belongs to one or more of four categories:

1) Knowledge and attitudes: Investigated knowledge and attitudes towards vaccinations (e.g. awareness, acceptability, intentions);
2) Affecting factors: Analysed factors affecting acceptability and uptake of vaccinations (e.g., age, gender, health status, socio-economic status, psychological motivations, peer and family influences, or other social determinants underpinning health behaviour);
3) Implementation strategies: Evaluated implementation strategies seeking to increase the acceptability and uptake of vaccines;
4) Intervention effectiveness: Evaluated the effectiveness of strategies seeking to increase the acceptability and uptake of vaccines.

To find out more about how to use this map and how the reviews were selected for inclusion in this database, read the section 'Using this map' below.

Review publication has grown steadily between 2010 (n=11) and 2019 (n=37), with many newer reviews investigating the implementation or effectiveness of intervention strategies seeking to increase vaccine uptake. The population focus of reviews span the life-course to include studies of children (n=52), adolescent (n=68) and adults (n=69). The focus of reviews varies considerably from Human Papillomavirus (HPV) vaccination targeting adolescents (n=46) to pertussis vaccines for pregnant women (n=1). Of the 40 reviews focused specifically on the uptake and/or acceptability flu vaccines the population focus ranged from the perspectives of parents, healthcare workers, to the general public and other population groups (e.g. carers, migrants, men/women).

*Footnote, searches were undertaken in January 2020. We are aware of a further six reviews of intervention effectiveness published during 2020, and these are listed under the section on 'Review scope'.

Using this map

There are various ways to view the map content. Take a brief moment to familiarise yourself with the various options.

1) View and filter the appearance of the map

The number of squares reflects the number of citations within each cell.

It is possible to filter the view of the map by clicking on the 'Filters' tab and selecting one or more sub-groups within the following categories: 1) Population focus; 2) type of vaccine by age group; 3) UK focus; and 4) publication date. Where more than one sub-group is selected within each category the default mode is set to 'OR', so that filtering is applied to any of the selected items within that category. For example, in the population focus category, if the sub-groups 'adults' and 'older adults' are selected, any citation described by either sub-group is displayed. When selecting sub-groups across categories the default mode is 'AND'. For example, if 'UK focus, Yes' is selected, along with the sub-groups 'adults' and 'older people', only those records focusing on adults or older people in the UK will be displayed. The settings can be changed using the filtering selection mode and clicking 'update'.

2) Explore citations within the map

Click on the cell of interest to view a list of citations represented in that cell.

You can also click on a column or row header to view all the citations relating to that row or column. For example, for all the records that focus only on 'Influenza only', click on the column heading titled, 'Influenza only'. For all the reviews focused on 'Affecting factors', click on the row heading titled, 'Affecting factors'.

To view the full set of reviews, click on the 'View Records' tab on the banner above the map.

Within the 'View Records' tab it is possible to filter the citations in two ways:

1) The filters on the left side correspond to the individual rows and columns in the map and the user can select or de-select these to view the citations that correspond to these cells.
2) The options on the top right banner enables the user to search by word or phrase in the title, abstract or author fields of the review citation.

Review scope

Citations were collected to identify what systematic review-level evidence exists on the acceptability and uptake of vaccines, delivered to children, young people or adults in high income countries, since 2010, and published in English. We did not examine in full the quality of the evidence. Citations which are on topic but did not indicate they conducted a systematic search of at least two databases were excluded. As this was a rapid scoping exercise of systematic reviews, the inclusion and coding was based on title and abstract only.

Searches for reviews were undertaken in Epistemonikos, specialist registers, medical and social science databases (CINAHL, PubMed, Social Sciences Citation Index, WHO Virtual Health Library), Microsoft Academic Graph and other sources, during January 2020, based on search concepts of: 1) vaccination; 2) uptake, coverage or beliefs; and 3) systematic reviews. 1,443 citations were screened on title and abstract after duplicate removal, to identify 194 reviews that met our inclusion criteria.

We are aware of six reviews of effectiveness published in 2020 since the map was developed. These were identified from the Database of Promoting Health Effectiveness Reviews (DoPHER) and listed here:

Acampora A, Grossi A, Barbara A, Colamesta V, Causio FA, et al. (2020) Increasing HPV Vaccination Uptake among Adolescents: A Systematic Review. International Journal of Environmental Research and Public Health 17.
Balzarini F, Frascella B, Oradini-Alacreu A, Gaetti G, Lopalco PL, et al. (2020) Does the use of personal electronic health records increase vaccine uptake? A systematic review. Vaccine.
de Cock C, van Velthoven M, Milne-Ives M, Mooney M, Meinert E (2020) Use of apps to promote childhood vaccination: Systematic review. JMIR mHealth and uHealth 8: e17371.
European Centre for Disease Prevention Control (2020) Systematic scoping review on social media monitoring methods and interventions relating to vaccine hesitancy. Stockholm Sweden: ECDC.
Flood T, Wilson IM, Prue G, McLaughlin M, Hughes CM (2020) Impact of school-based educational interventions in middle adolescent populations (15-17yrs) on human papillomavirus (HPV) vaccination uptake and perceptions/knowledge of HPV and its associated cancers: A systematic review. Preventive medicine 139: 106168.
Hutchinson AF, Smith SM (2020) Effectiveness of strategies to increase uptake of pertussis vaccination by new parents and family caregivers: A systematic review. Midwifery 87: 1-12.

Suggested citation

Dickson K, Stansfield C, Kwan I, Khatwa M (2021) Acceptability and uptake of vaccines: Rapid map of systematic reviews. London: EPPI-Centre, Social Science Research Unit, UCL Institute of Education, University College London.

Funding

This review was commissioned by the National Institute for Health Research (NIHR) Policy Research Programme (PRP) for the Department of Health and Social Care (DHSC) and Public Health England (PHE). It was funded through the NIHR PRP contract with the EPPI Centre at UCL (Reviews facility to support national policy development and implementation, PR-R6-0113-11003). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the DHSC.

The Department of Health and Social Care Reviews Facility is a collaboration between the following centres of excellence:
UCL Institute of Education
EPPI-Centre (Evidence for Policy and Practice Information and Co-ordinating Centre)
London School of Hygiene & Tropical Medicine
University of York Centre for Reviews and Dissemination

Funder involvement

This work is part of an ongoing programme of work funded by DHSC. Throughout the review, PHE policy team members were consulted to understand the context of the issue under study, and to identify the focus and scope of the analysis.

Conflicts of interest

There were no conflicts of interest in the writing of this report.

Contributions

The opinions expressed in this publication are not necessarily those of the EPPI-Centre or the funders. Responsibility for the views expressed remains solely with the authors.

(c) Copyright

Authors of the systematic reviews on the EPPI-Centre website http://eppi.ioe.ac.uk hold the copyright for the text of their reviews. The EPPI-Centre owns the copyright for all material on the website it has developed, including the contents of the databases, manuals, and keywording and data-extraction systems. The centre and authors give permission for users of the site to display and print the contents of the site for their own noncommercial use, providing that the materials are not modified, copyright and other proprietary notices contained in the materials are retained, and the source of the material is cited clearly following the citation details provided. Otherwise users are not permitted to duplicate, reproduce, re-publish, distribute, or store material from this website without express written permission.