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Vaccine acceptability, uptake and completion amongst men who have sex with men: a systematic review, meta-analysis and theoretical framework

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posted on 2023-06-10, 00:04 authored by Tom Nadarzynski, Miles Frost, Danny Miller, Christopher W Wheldon, Brenton M Wiernik, Huachun Zou, Daniel Richardson, Laura A V Marlow, Helen Smith, Christina Jones, Carrie LlewellynCarrie Llewellyn
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 accept ability, 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 associ ated 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 vac cine completion 47% (median = 45%, range: 12%-89%). Six categories of factors associated with vaccina tion 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 pro motion campaigns); and National, state and local policy environment (e.g., public health guidelines tar geting 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 deter minants, as outlined in our theoretical framework, will help guide interventions to increase vaccine com pletion among MSM.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

Vaccine

ISSN

0264-410X

Publisher

Elsevier

Issue

27

Volume

39

Page range

3565-3581

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2021-06-11

First Open Access (FOA) Date

2022-05-25

First Compliant Deposit (FCD) Date

2021-06-11

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