Evidence map›Paper›PMID 41985976›Full record

SynthesisBMJ (Clinical research ed.)2026

Effectiveness of interventions to increase vaccine uptake: component network meta-analysis.

Sarah R Davies, Annabel L Davies, Julian P T Higgins, Deborah M Caldwell, Zak A Thornton, Elisabeth Aiton, Ifra Ali, Sarah Dawson, Carmel McGrath, Thomas Parkhouse and 6 more

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Sarah R DaviesPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK Sarah.r.davies@bristol.ac.uk.ORCID https://orcid.org/0000-0003-1321-7826
Annabel L DaviesPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK Sarah.r.davies@bristol.ac.uk.
Julian P T HigginsPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Deborah M CaldwellPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Zak A ThorntonPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Elisabeth AitonPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Ifra AliNIHR Health Protection Research Unit in Vaccines and Immunisation, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Sarah DawsonPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Carmel McGrathNIHR Health Protection Research Unit in Evaluation and Behavioural Science at University of Bristol, Bristol, UK.
Thomas ParkhousePopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Lucy YardleyNIHR Health Protection Research Unit in Evaluation and Behavioural Science at University of Bristol, Bristol, UK.
Julie YatesUK Health Security Agency, London, UK.
Louise LetleyUK Health Security Agency, London, UK.
Sharif A IsmailDepartment of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Hannah ChristensenPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Clare E FrenchPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo identify the effective components of interventions to increase vaccine uptake and to explore variations in effectiveness by population group and in relation to the covid-19 pandemic.

designComponent network meta-analysis.

settingSystematic review of randomised controlled trials in high and upper middle income countries.

participants237 studies with 570 intervention arms and 4 361 717 participants.

interventionsAny intervention targeting vaccine recipients or their caregivers aiming to increase demand for, or access to, vaccinations on the UK immunisation schedule. Key content and delivery features of interventions were identified using a bespoke coding framework co-developed with stakeholders.

main outcome measuresThe outcome of interest was vaccine uptake. Bayesian component level meta-regression estimated relative effects of intervention components as ratios of odds ratios with 95% credible intervals (CrIs).

resultsOf the included studies, 110 were at low risk of bias, 96 had some concerns, and 31 were at high risk. 40% (n=1 744 686) of the participants were male. For children, there was evidence of beneficial effects for payments to cover costs (ratio of odds ratios 3.01, 95% CrI 1.49 to 6.06) and decision aids (2.73, 1.14 to 7.06), and some evidence for extended opportunities (1.37, 0.98 to 1.95) and social factors (1.27, 0.99 to 1.65). For adolescents and young adults, there were beneficial effects for personal delivery formats (2.13, 1.09 to 4.40), delivery by community members alongside healthcare professionals (6.42, 1.94 to 25.62), and social factors (2.62, 1.45 to 5.04), and negative effects for decision aids (0.43, 0.18 to 0.98) and human versus non-human interaction (0.47, 0.21 to 1.02). For adults, beneficial effects were shown for human interaction (1.86, 1.42 to 2.45), extended opportunities (1.63, 1.35 to 2.00), help with appointment scheduling (1.38, 1.06 to 1.78), payments to cover costs (1.47, 1.03 to 2.16), and motivational interviewing (1.79, 1.21 to 2.64), and there was some evidence for financial incentives (1.15, 0.99 to 1.35) and information on vaccine safety and/or efficacy (1.15, 0.99 to 1.32). For adults, evidence also showed a negative effect of non-human interaction versus no interaction (0.72, 0.57 to 0.92). Subgroup analyses showed variation for underserved populations and in relation to the covid-19 pandemic (before 2020 and 2020 onwards).

conclusionOverall, extended opportunities, appointment scheduling help, financial incentives, payments to cover costs, and motivational interviewing were effective content components of interventions to increase vaccine uptake. Effective delivery components overall were human interaction and delivery by community members alongside healthcare professionals. However, effective components varied by age group, for underserved populations, and in analyses investigating the impact of the covid-19 pandemic. These findings have important implications for designing, optimising, and implementing targeted interventions, highlighting which components are effective across different populations and contexts. Consideration of the economic data on interventions should further support resource informed decision making.

Indexed as

COVID-19COVID-19 VaccinesImmunization ProgramsVaccinationAdherence InterventionsBayes TheoremHumansPandemicsRandomized Controlled Trials as TopicSARS-CoV-2COVID-19 Vaccines

Identifiers

PMID41985976
PMCPMC13081225

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.