Interventions effective in increasing influenza vaccination rates

Clinical question: 
How effective are access, provider, system and societal interventions in increasing the uptake of influenza vaccination in people aged 60 years and older in the community?
Bottom line: 
Effective interventions for increasing community demand were a letter plus leaflet/postcard (compared with a letter), nurses/pharmacists educating plus vaccinating patients, a phone call from a senior, a telephone invitation rather than clinic drop-in, free groceries lottery and nurses educating and vaccinating patients. Effective interventions for enhancing vaccination access were home visits (compared with clinic invitation), free vaccine and patient group visits. Effective provider/system interventions were paying physicians, reminding physicians about all their patients, posters plus postcards, chart review/feedback and educational outreach/feedback.
Caveat: 
Trials did not report adverse events. There were no trials of interventions at a societal level. A key problem was measuring how complete the assessment of influenza vaccination was, as in most of the US studies it was possible for participants to receive vaccination at walk-in clinics and during campaigns, instead of their regular clinics; some studies did not perform independent verification of the accuracy and completeness of their clinic records or financial billings.
Context: 
Many health authorities recommend influenza vaccination of older people. However, vaccination uptake in people aged 60 and older varies across countries, socioeconomic and health-risk groups. It is important to identify effective interventions to increase influenza vaccination uptake.
Review CD#: 
CD005188
PEARLS No: 
447
Date: 
November, 2014
Authored by: 
Brian R McAvoy