The Effectiveness of Interventions for Increasing COVID-19 Vaccine Uptake: A Systematic Review

Abstract

Vaccination is vital to protect the public against COVID-19. The aim of this systematic review is to identify and evaluate the effectiveness of interventions to increase COVID-19 vaccine uptake. We searched a range of databases (Embase, Medline, Psychology & Behavioral Science, PsycInfo, Web of Science and NIH Preprints Portfolio) from March 2020 to July 2021 for studies which reported primary quantitative or qualitative research on interventions to increase COVID-19 vaccine uptake. Outcome measures included vaccination uptake and reported intention to vaccinate. Reviews, position papers, conference abstracts, protocol papers and papers not in English were excluded. The NHLBI quality assessment was used to assess risk of bias. In total, 39 studies across 33 papers met the inclusion criteria. A total of 28 were assessed as good quality. They included interventions relating to communication content, communication delivery, communication presentation, policy or vaccination delivery, with 7 measuring vaccination uptake and 32 measuring vaccination intention. A narrative synthesis was conducted, which highlighted that there is reasonable evidence from studies investigating real behaviour suggesting that personalising communications and sending booking reminders via text message increases vaccine uptake. Findings on vaccination intention are mixed but suggest that communicating uncertainty about the vaccine does not decrease intention, whereas making vaccination mandatory could have a negative impact. Although much of the research used experimental designs, very few measured real behavioural outcomes. Understanding which interventions are most effective amongst vaccine-hesitant populations and in the context of booster vaccinations will be important as vaccine roll outs continue across the world.

Politics of COVID-19 vaccine mandates: Left/right-wing authoritarianism, social dominance orientation, and libertarianism

“…To boost vaccination rates and achieve herd immunity, various mandatory and punitive vaccination policies are being proposed or implemented, such as requiring vaccination certificates for public activities and firing employees who refuse vaccination. While vaccine mandates may be an important policy tool to reach near-universal vaccination, mandatory policies could result in more resistance among the public ( Batteux, Mills, Jones, Symons, & Weston, 2022 ; Schmelz & Bowles, 2022 ). Vaccine mandates have raised considerable objections: protests against COVID-19 vaccination have broken out in multiple countries ( Smith, 2022 ); the vaccine mandate for employees at large companies from the Biden administration has been blocked ( Sherman, 2022 ).…”

Drivers of the Intention to Receive a COVID-19 Booster Vaccine: Insights from the UK and Australia

“…Evidence regarding the efficacy of such interventions is mixed; some studies have reported increased vaccine intent [ 44 , 45 , 46 , 47 , 48 , 49 ], and others not [ 50 , 51 , 52 , 53 , 54 ]. However, recent meta-analysis suggests that information regarding vaccine efficacy may be of particular relevance to those most hesitant [ 55 ]. Additional research provides preliminary evidence that emphasising vaccine efficacy may also increase COVID-19 vaccine uptake [ 56 , 57 ].…”

Between persuasion and compulsion: The case of COVID-19 vaccination in Canada

“…The important polarization and politization of vaccination in the COVID-19 context indicate that comparison with other mandatory programs should be made with caution. In their review on effectiveness of interventions for increasing COVID-19 vaccine uptake, Batteux and colleagues concluded that mandating vaccination is unlikely to be an effective strategy to increase vaccination uptake [44] , especially in individuals with low vaccination intentions. Moreover mandates can affect the receipt of future doses or increase inequalities [44] .…”

“…In their review on effectiveness of interventions for increasing COVID-19 vaccine uptake, Batteux and colleagues concluded that mandating vaccination is unlikely to be an effective strategy to increase vaccination uptake [44] , especially in individuals with low vaccination intentions. Moreover mandates can affect the receipt of future doses or increase inequalities [44] . Even if some studies concluded that disincentives strategies did increase COVID-19 vaccine uptake [45] , another study [46] suggested that vaccine passports may lead to a lower vaccination intention in socio-demographic groups that are less confident in COVID-19 vaccines.…”