Intervention for the Increase in the Uptake of Pneumococcal Vaccination Among Older Patients: A Systematic Review and Meta-Analysis.

Abstract

Pneumococcal infection is a significant cause of morbidity and mortality among older adults, with lasting impacts on daily functioning and frailty. Although pneumococcal vaccination is a proven preventive measure, uptake remains low in many primary care settings. This systematic review examined the effectiveness of interventions designed to increase pneumococcal vaccination uptake among older patients in primary care. A comprehensive literature search was conducted in PubMed, Embase, and Web of Science for studies published between January 1995 and April 2025. Studies eligible for inclusion were randomized controlled trials or quasi-experimental studies targeting individuals aged 65 or older. Out of 166 identified records, five studies met the inclusion criteria. Interventions varied widely, including low-literacy educational brochures, computerized physician reminder systems, mailed feedback, point-of-care flyers, and comprehensive system-level programs. All interventions positively affected vaccination uptake, with absolute increases ranging from 1.9% to 35% compared to controls. Strategies targeting healthcare providers, mainly through reminders and feedback mechanisms, tended to yield higher improvements. Only one study was conducted in Asia, indicating a significant gap in regional evidence. The findings suggest that simple and multicomponent interventions can effectively improve pneumococcal vaccination rates in older adults when implemented through primary care. Greater attention to interdisciplinary collaboration and the use of context-specific strategies is warranted. Further trials, particularly in Asian and resource-limited settings, are needed to inform sustainable, scalable approaches to increasing vaccination coverage.