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

Nadarzynski, T., Frost, M., Miller, D., Wheldon, Christopher W., Wiernik, Brenton M., Zou, Huachun, Richardson, Daniel, Marlow, L., Smith, Helen, Jones, C. and Llewellyn, C. 2021. Vaccine acceptability, uptake and completion amongst men who have sex with men: A systematic review, meta-analysis and theoretical framework. Vaccine. 39 (27), pp. 3565-3581. https://doi.org/10.1016/j.vaccine.2021.05.013

TitleVaccine acceptability, uptake and completion amongst men who have sex with men: A systematic review, meta-analysis and theoretical framework
TypeJournal article
AuthorsNadarzynski, T., Frost, M., Miller, D., Wheldon, Christopher W., Wiernik, Brenton M., Zou, Huachun, Richardson, Daniel, Marlow, L., Smith, Helen, Jones, C. and Llewellyn, C.
AbstractBackground: 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.
KeywordsGay
Bisexual
MSM
HPV
Meningitis
HAV
HBV
vaccination
JournalVaccine
Journal citation39 (27), pp. 3565-3581
ISSN0264-410X
Year2021
PublisherElsevier
Accepted author manuscript
License
CC BY-NC-ND 4.0
File Access Level
Open (open metadata and files)
Digital Object Identifier (DOI)https://doi.org/10.1016/j.vaccine.2021.05.013
Publication dates
Published online24 May 2021
Published in print16 Jun 2021

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