SynthesisVaccine2026
Characteristics of successful and unsuccessful strategies to increase vaccine intention and improve vaccine uptake for U.S. adult populations in the Affordable Care Act era (2010-2025): a systematic review and meta-regression.
Synthesis in Vaccine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundVaccine-preventable diseases continue to burden U.S. population health. Despite the Affordable Care Act (ACA) eliminating cost-sharing for recommended vaccines in 2010, adult vaccination rates persistently fall below Healthy People 2030 targets, signaling that access alone is insufficient.
objectivesTo synthesize peer-reviewed literature (2010-2025) on interventions designed to increase vaccine intention or uptake among U.S. adults; characterize strategies, populations, settings, and study quality; and identify predictors of vaccine uptake rate.
methodsFollowing PRISMA 2020 guidelines, a multi-database search was conducted across PubMed, Web of Science, Ovid/MEDLINE, and EBSCOhost, with a final updated search in December 2025. Dual independent reviewers screened studies in two stages. Quality was assessed using the EPHPP tool and certainty evaluated using GRADE. Strategies were categorized per the WHO Behavioral and Social Drivers of Vaccination (BeSD) Model. A meta-regression was conducted on 79 studies, with narrative synthesis across all 92 included studies.
resultsOf 11,219 records, 92 studies were included. Study designs were predominantly RCTs; Influenza and COVID-19 vaccines were most commonly studied. In the meta-regression (adjusted R
conclusionsEffective adult vaccination strategies were multifactorial. Service quality improvement, priority population focus, and community-based recruitment were the strongest predictors of higher uptake. Findings support the WHO BeSD model's Practical Issues domain: reducing friction outperformed persuasion alone. GRADE certainty remained LOW to MODERATE, emphasizing the need for higher-quality, equity-focused research. REGISTRATION: This systematic review was registered at Open Science Framework: 10.17605/OSF.IO/SM7YD.
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Registered trials
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 Socratic graph.