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. 2023 May 15;25:e45493. doi: 10.2196/45493

Table 1.

Characteristics of 7 included studies.

Authors (year); country Targeted vaccine and population Study type, time frame, and perspective Interventions
  • Base-case and sensitivity analyses

Web-based decision aid

Tubeuf et al (2014) [30]; United Kingdom MMRa vaccine; 3- to 12-month-old individuals Trial-based analysis; 17 months;
National Health Service and societal perspective
(1) MMR web-based decision aid and usual practice,
(2) MMR leaflet and usual practice, and
(3) usual practice
  • Base-case analysis: web-based decision aid with usual practice—cost-saving and higher vaccination rate

  • Sensitivity analysis: probability of web-based decision aid to be cost-effective was 72%-88% at WTPb threshold of £0-£100 (US $0-US $124.35)

Television campaign

Kim and Yoo (2015) [24]; United States Influenza vaccination; Medicare individuals aged 65 years and older Decision tree model; 1 year; societal perspective (1) Television (nationwide) campaign and
(2) no television campaign
  • Base-case analysis: television campaign—US $17.79 cost per additional case vaccinated

  • Sensitivity analysis: television campaign remained cost-effective if vaccination coverage rate increased with television campaign (by at least 0.5%) for non-Hispanic White or broadcasting cost <US $14,870,000; mean ICERc US $23.54 (95% CI US $14.21-US $39.37) in 10,000 Monte-Carlo simulations


SMS text messaging

Kawakatsu et al (2020) [29]; Nigeria Childhood vaccination; younger than 12 months Trial-based analysis; 14 weeks; government’s perspective (1) SMS text messaging reminder
(2) no intervention
  • Base-case analysis: US $7.9 cost per additional return case

  • Sensitivity analysis: two scenario analyses (excluded appointments and used the inverse-probability weighted method) found effectiveness results to be robust


Recall and reminder by telephone/computer

Lieu et al (1997) [25]; United States MMR vaccine; 20-month-old individuals Decision tree model; 4 months; payer’s perspective (1) Computer-generated recall letters and
(2) no intervention
  • Base-case analysis: US $4.04 cost per additional child immunized

  • Sensitivity analysis: influential factors were effectiveness of recall letters and the baseline population coverage rate

  • Scenario analyses: US $2.14 per additional child immunized using telephone autodialer compared with no intervention


Lieu et al (1998) [26]; United States Childhood immunization; 20-month-old individuals Decision tree model; 4 months; payer’s perspective (1) Automated telephone message alone,
(2) letter alone,
(3) letter followed by an automated telephone message, and (4) no intervention
  • Base-case analysis (vs no intervention) cost per additional child immunized: letter followed by automated telephone message: US $7.00

  • Automated telephone message alone: US $9.80; letter alone: US $10.50

  • Sensitivity analysis: cost per child immunized in automated telephone message alone decreased from US $9.8 to US $2.20 when lower cost per telephone message was applied


Franzini et al (2000) [28]; United States Childhood immunization; <1 year of age Trial-based analysis; 1 year;
societal perspective
(1) Computer-autodialer reminder, (2) manual postcard mail, and (3) no intervention
  • Base-case analysis (vs no intervention): cost per return visit—computer autodialer: US $3.48; manual mail: US $9.52. Cost per return immunization: computer autodialer: US $4.06; manual mail: US $12.82

  • Sensitivity analyses: influential factors were effectiveness of computer-autodialer in return visit and immunization and start-up costs of computer-autodialer system



Spencer et al (2020) [27]; United States HPVd vaccine; 11-17 years old Dynamic simulation model, 50 years; government’s perspective (1) Reminder and recall (phone call, email, text, or mailing), (2) QIe visit, and (3) school-located vaccination

  • Base-case analysis (vs no intervention): QI visits: US $1538/QALYf reminder and recall: US $13,183/QALY; school-located vaccination: US $14,871/QALY; (WTP=US $50,000/QALY)

  • Sensitivity analysis: Probability of being cost-effective was 83% for school-located vaccination, 12% for reminder and recall, and 5% for QI visit at a WTP of US $50,000 per QALY gained

aMMR: measles-mumps-rubella.

bWTP: willingness-to-pay.

cICER: incremental cost-effectiveness ratios.

dHPV: human papillomavirus.

eQI: quality improvement.

fQALY: quality-adjusted life years.