title: Increasing Coverage of Appropriate Vaccinations: A Community Guide Systematic Economic Review.
abstract: Population-level coverage for immunization against many vaccine-preventable diseases remains below optimal rates in the U.S. The Community Preventive Services Task Force recently recommended several interventions to increase vaccination coverage based on systematic reviews of the evaluation literature. The present study provides the economic results from those reviews.
  
  
  
  A systematic review was conducted (search period, January 1980 through February 2012) to identify economic evaluations of 12 interventions recommended by the Task Force. Evidence was drawn from included studies; estimates were constructed for the population reach of each strategy, cost of implementation, and cost per additional vaccinated person because of the intervention. Analyses were conducted in 2014.
  
  
  
  Reminder systems, whether for clients or providers, were among the lowest-cost strategies to implement and the most cost effective in terms of additional people vaccinated. Strategies involving home visits and combination strategies in community settings were both costly and less cost effective. Strategies based in settings such as schools and MCOs that reached the target population achieved additional vaccinations in the middle range of cost effectiveness.
  
  
  
  The interventions recommended by the Task Force differed in reach, cost, and cost effectiveness. This systematic review presents the economic information for 12 effective strategies to increase vaccination coverage that can guide implementers in their choice of interventions to fit their local needs, available resources, and budget.
authors: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia. Electronic address: hir0@cdc.gov.
authors: Verughese
authors: V
authors: Jacob
authors: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
authors: Sajal K
authors: SK
authors: Chattopadhyay
authors: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
authors: David P
authors: DP
authors: Hopkins
authors: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
authors: Jennifer
authors: J
authors: Murphy Morgan
authors: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
authors: Adesola A
authors: AA
authors: Pitan
authors: National Forum for Heart Disease and Stroke Prevention, Washington, District of Columbia.
authors: John M
authors: JM
authors: Clymer
mesh_terms: D003362:Cost-Benefit Analysis; D006792:House Calls; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D017589:Immunization Programs / Q000379:methods*; D017010:Reminder Systems / Q000191:economics; D014481:United States; D014611:Vaccination