A scoping review of published and unpublished U.S. literature (searched December 2023) evaluating quality improvement (QI) programs aimed at increasing adult immunization coverage across healthcare provider settings.
Of 272 included studies, 81% of the 212 that assessed vaccine coverage found a statistically significant increase after QI programs — including 72% of RCTs, 85% of quasi-experimental studies, and 89% of cohort studies. The most targeted vaccines were influenza (64%) and pneumococcal (43%); the most common strategies were patient education (49%), patient reminders (38%), provider reminders (36%), and provider education (35%).
- Scoping review design does not permit formal meta-analytic pooling or effect-size estimation across studies. - Restricts to U.S.-based programs, limiting global generalizability. - Does not identify which specific QI components drive the largest coverage gains.
Most adult immunization QI programs — especially those combining patient and provider reminders with education — lead to measurable coverage gains; clinicians and health systems can prioritize these strategies while awaiting evidence on which individual components matter most.
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