Table 2 A descriptive summary of the target vaccine, reason for hesitancy, outcomes, and limitations for each strategy
From: Strategies to overcome vaccine hesitancy: a systematic review
Author | Duration of study | Target vaccine | Reason for vaccine hesitancy | Outcome of interventions | Limitations of the study |
|---|---|---|---|---|---|
Community health training | |||||
 Oche et al., 2011 [15] | 9 months | DPT3 | Low level of knowledge among mothers and poor attitude of health workers | Improved program acceptance and immunization services | Cost of services, availability of vaccines not considered |
 Brugha et al., 1996 [16] | 8 months | BCG; poliovirus, DPT3, measles | Lack of awareness | Improvement of immunization coverage through community health training. | Contamination of control group |
 Rahman et al., 2013 [17] | 6 months | DPT1, DPT2, DPT3, Measles | Lack of information/motivation | Vaccination coverage rates improved in intervention villages | Study restricted to a tribe influenced by peer-leader |
 Williams et al., 2019 [47] | 5 months | Influenza | Religious beliefs/attitude | No significant outcome | Small study size |
 Nasiru et al., 2012 [21] | 6 months | Polio vaccine | Attitude/misinformation | Effective communication and polio outreach campaigns-increased vaccine uptake | Population dynamics not considered |
 Ofstead et al., 2013 [22] | 3 months | Influenza | Misconceptions | Substantial increase in vaccination rate | No psychometric evaluation |
 Usman et al., 2011 [23] | 90 days | DTP | Lack of knowledge | Infant vaccination increased | Lack of complete follow-up |
 Spleen et al., 2011 [19] | 1 year | HPV vaccine | Lack of parental attitude/knowledge | Increased vaccine acceptability | Study limited to small parent sub-group |
 Lau et al., 2012 [20] | 6 months | Influenza | Lack of knowledge | Improved uptake of influenza vaccination and utilization of health services | Seasonal variations of influenza not considered. |
Incentive-based approach | |||||
 Mouzoon et al., 2010 [24] | 6 years | Influenza | Lack of familiarity or comfort with vaccination in pregnancy | Vaccination acceptability increased in pregnant females | Lack of baseline data |
 Banerjee et al., 2010 [25] | 18 months | BCG, DPT, oral polio vaccines, measles | Lack of awareness | Increased uptake of immunization services. | Not a blinded study |
 Stitzer et al., 2009 [27] | 6 months | HBV | Negligence | Motivation leading to attending vaccination sessions | Small sample size, homogeneity of sample |
 Barham et al., 2008 [26] | 2 years | BCG, MCV, OPV3, DPT3 | Lack of finance and motivation | Vaccination coverage increased dramatically | Proximity to availability of vaccine to study group not considered |
 Robertson et al., 2013 [28] | 1 year | Childhood vaccination | Lack of motivation | No increase in vaccination uptake | Short intervention period |
Technology-based health literacy | |||||
 Ansari et al., 2007 [29] | 1-day study | Polio vaccine | Misguided information/rumors | Correct health education leading to vaccine acceptance | Other parameters and lack of existing immunization not considered |
 Williams et al., 2013 [18] | 2 months | Pertussis, varicella, pneumococcal | Negative parent attitude regarding safety/necessity of vaccine | Educational intervention with 8-min video improved vaccine acceptance | Social desirability bias |
 Maltezou et al., 2009 [30] | 1 year | Influenza | Lack of time and inconvenience | Lectures in hospital/mobile vaccination team visit-significant impact | No baseline data; no feedback |
 Fiks et al., 2013 [31] | 1 year | HPV | Parental concerns, clinicians’ beliefs and practice concerns. | Combined interventions increased vaccination rates | Lack of large-scale study |
 Muehleisen et al., 2007 [32] | 9 months | DTAP, HBV, HiB, IPV, MMR, Td | Lack of parental awareness | Increased reporting of immunization | Improper documentation/lack of prior immunization records, single-centric study |
 Ahlers-Schmidt et al., 2010 [33] | Not mentioned | General vaccine | Parental concerns about safety and lack of knowledge | Increased vaccine acceptability | Demographically not generalizable |
 Cates et al., 2011 [34] | 6 months | HBV | Lack of awareness | Increase in vaccination acceptance and uptake | Socio-economic disparity in demographics |
 Pandey et al., 2011 [35] | Not mentioned | HPV | Inadequate information | Female students had better awareness; medical teaching had better impact | Single-centric study |
Media-based approach | |||||
 Brown et al. 2015 [44] | Not mentioned | Routine vaccine | Not mentioned | 60% mothers preferred immunization reminders by cellphones and SMS | Study not including rural population |
 Saville et al., 2014 [45] | 4 months | General vaccine | Not mentioned | Preferred modality email or telephone | Socio-economic demography not generalizable |
 Hofstetter et al., 2013 [43] | 3 months | General vaccine | Not mentioned | Text messages recall widely accepted | Socio-demographic data not generalizable |
 Kharbanda et al., 2009 [42] | Not mentioned | General vaccine | Not mentioned | Preferred method was text messages | Demographically not generalizable |
 Clark et al., 2015 [41] | Not mentioned | General vaccination | Not mentioned | Parents more willing to communicate by phone call | Lack of specificities |
 Lemstra et al., 2011 [40] | 1 year | MMR | Low income | Limited additional benefits | Substantial study population not able to be contacted; incorrect telephone data |
 Milkman et al., 2011 [38] | 1 month | Influenza | Lack of knowledge | Increased vaccination rate | Small sample size; single-centric study |
 Stockwell et al., 2012 [37] | 6 months | Meningococcal (MCV4); tetanus diphtheria-acellular pertussis (Tdap) | Low income | Immunization reminders beneficial; increased vaccine uptake | Lack of sample size of parents recorded in cell phone registry |
 Zhang et al., 2019 [36] | Not mentioned | Acceptance of new target vaccination policy | Negative attitude towards immunization | Public figures/media messages can influence attitudes | Small study size. Did not identify demographic predictors |
 Garcia-Dia, 2017 [46] | 3 months | Routine vaccine | Lack of awareness | Preference of text message along with Picture | Study conducted only in rural setting |
 Moniz et al., 2013 [39] | 2 years | Influenza | Lack of awareness | Text messages not effective | Single socio-demographic group |