TY - JOUR
T1 - Vaccine acceptability, uptake and completion amongst men who have sex with men
T2 - A systematic review, meta-analysis and theoretical framework
AU - Nadarzynski, Tom
AU - Frost, Miles
AU - Miller, Danny
AU - Wheldon, Christopher W
AU - Wiernik, Brenton M
AU - Zou, Huachun
AU - Richardson, Daniel
AU - Marlow, Laura A V
AU - Smith, Helen
AU - Jones, Christina J
AU - Llewellyn, Carrie
N1 - Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/6/16
Y1 - 2021/6/16
N2 - BACKGROUND: Due to an increased risk of sexually transmitted infections (STIs), gay, bisexual and other men who have sex with men (MSM) have been recommended to receive vaccinations against human papillomavirus, meningitis C and hepatitis A/B. This review aimed to compare the rates of vaccine acceptability, uptake and completion, and to identify determinants of vaccine outcomes specific to MSM to inform a theoretical framework.METHODS: In January 2020 four databases were explored to identify vaccination behaviours and associated factors among MSM. A narrative systematic review and meta-analysis were performed. Data were synthesised for theoretical modelling.RESULTS: Seventy-eight studies, mostly from the USA, were included. The average vaccine acceptability was 63% (median = 72%, range: 30%-97%), vaccine uptake 45% (median = 42%, range: 5%-100%) and vaccine completion 47% (median = 45%, range: 12%-89%). Six categories of factors associated with vaccination acceptability, uptake and completion were conceptualised: Individual (e.g., demographic and psychosocial); Interpersonal (e.g., peer education); Healthcare provider (e.g., vaccine recommendation); Organisational and practice setting (e.g., routine collection of patient sexual orientation information that is integrated into a clinical decision support system); Community environment (e.g., targeted health promotion campaigns); and National, state and local policy environment (e.g., public health guidelines targeting MSM).CONCLUSION: Despite overall high levels of acceptability, uptake and completion rates were below targets predicted by cost-effectiveness modelling across all recommended vaccines. These parameters may need to be adjusted for more precise estimations of cost-effectiveness. Addressing the multiple levels of determinants, as outlined in our theoretical framework, will help guide interventions to increase vaccine completion among MSM.
AB - BACKGROUND: Due to an increased risk of sexually transmitted infections (STIs), gay, bisexual and other men who have sex with men (MSM) have been recommended to receive vaccinations against human papillomavirus, meningitis C and hepatitis A/B. This review aimed to compare the rates of vaccine acceptability, uptake and completion, and to identify determinants of vaccine outcomes specific to MSM to inform a theoretical framework.METHODS: In January 2020 four databases were explored to identify vaccination behaviours and associated factors among MSM. A narrative systematic review and meta-analysis were performed. Data were synthesised for theoretical modelling.RESULTS: Seventy-eight studies, mostly from the USA, were included. The average vaccine acceptability was 63% (median = 72%, range: 30%-97%), vaccine uptake 45% (median = 42%, range: 5%-100%) and vaccine completion 47% (median = 45%, range: 12%-89%). Six categories of factors associated with vaccination acceptability, uptake and completion were conceptualised: Individual (e.g., demographic and psychosocial); Interpersonal (e.g., peer education); Healthcare provider (e.g., vaccine recommendation); Organisational and practice setting (e.g., routine collection of patient sexual orientation information that is integrated into a clinical decision support system); Community environment (e.g., targeted health promotion campaigns); and National, state and local policy environment (e.g., public health guidelines targeting MSM).CONCLUSION: Despite overall high levels of acceptability, uptake and completion rates were below targets predicted by cost-effectiveness modelling across all recommended vaccines. These parameters may need to be adjusted for more precise estimations of cost-effectiveness. Addressing the multiple levels of determinants, as outlined in our theoretical framework, will help guide interventions to increase vaccine completion among MSM.
KW - Female
KW - Health Knowledge, Attitudes, Practice
KW - Homosexuality, Male
KW - Humans
KW - Male
KW - Papillomavirus Infections
KW - Papillomavirus Vaccines
KW - Patient Acceptance of Health Care
KW - Sexual and Gender Minorities
KW - Vaccination
UR - http://www.scopus.com/inward/record.url?scp=85107877623&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2021.05.013
DO - 10.1016/j.vaccine.2021.05.013
M3 - Review article
C2 - 34034949
SN - 0264-410X
VL - 39
SP - 3565
EP - 3581
JO - Vaccine
JF - Vaccine
IS - 27
ER -