Some interventions effective in increasing influenza vaccination rates of older people

Clinical question: 
How effective are interventions to increase influenza vaccination rates in those 60 years and older in the community?
Bottom line: 
Personalised postcards or phone calls were effective, and home visits, and facilitators, may be effective. Reminders to physicians were not. Only 11 of 44 randomised controlled trials (RCTs) were at low or moderate risk of bias. They included 3 of the 13 personalised postcard/phone call interventions (all 3 effective), 2 of the 4 home visit interventions (both effective, but 1 small and with imbalances in the study arms), 3 of the 4 reminders to physicians interventions (none effective), and 3 of the 4 facilitator interventions (2 effective).
Caveat: 
The other 33 RCTs were at high risk of bias, and the limited results of the RCTs at low and moderate risk of bias should be viewed in this context. Heterogeneity was marked and metaanalysis was limited. All the identified RCTs were of older people in the community, and conducted in high-income countries. There were no RCTs of interventions to increase influenza vaccination rates in institutions.
Context: 
There is uncertainty about the effectiveness of interventions to increase influenza vaccination rates in those 60 years or older. Although the evidence to support influenza vaccination is poor, it is promoted by many health authorities.
Review CD#: 
CD005188
PEARLS No: 
307
Date: 
April, 2011
Authored by: 
Brian R McAvoy