PREPRINT version 3: A rapid systematic review of public responses to health messages encouraging vaccination against infectious diseases in a pandemic or epidemic

Sadie Lawes-Wickwar *, Daniela Ghio, Mei Yee Tang, Chris Keyworth, Sabina Stanescu, Juliette Westbrook, Elizabeth Jenkinson, Angelos P Kassianos, Daniel Scanlan, Natalie Garnett, Lynn Laidlaw, Neil Howlett, Natalie Carr, Natalia Stanulewicz, Ella Guest, Daniella Watson, Lisa Sutherland, Lucie Byrne-Davis, Angel Chater, Jo HartChristopher Armitage, Gillian Shorter, Vivian Swanson, Tracy Epton

*Corresponding author for this work

Research output: Working paper


Background: Public health teams need to understand how the public responds to vaccination messages in a pandemic or epidemic to inform successful campaigns encouraging the uptake of new vaccines as they become available.
Methods: A rapid systematic review was performed by searching PsycINFO, MEDLINE,, OSF Preprints and PsyArXiv Preprints in May 2020 for studies including at least one health message promoting vaccine uptake of droplet spread viruses. Non-English language studies and dissertations were excluded in line with using rapid review methodology. Included studies were assessed for quality using the MMAT or AMSTAR, and for patient and public involvement (PPI) in designing and/or conducting the research.
Results: Thirty-five articles were included. Most reported messages for seasonal influenza (n=11; 31%) or H1N1 (n = 11; 31%) and only seven studies (20%) sampled vulnerable populations at higher risk of mortality/morbidity from viruses, e.g. older adults. Evidence from moderate to high quality studies for improving vaccine uptake included providing: information about virus risks, vaccination safety, and addressing misunderstandings about vaccination, vaccination reminders, detail about vaccination clinics and their locations, and mixed media campaigns at scale across hospitals or communities. Behavioural influences (beliefs and intentions) were improved when shorter messages, risk-reducing, or relative risk framing was used, the benefits of vaccination to society were emphasised, and beliefs about capability to be vaccinated and concerns among target populations (e.g. about vaccine safety) were addressed. Clear, credible, messages in language target groups can understand were found acceptable. Two studies (6%) described PPI in the research process.
Conclusions: This review has identified effective messages to encourage vaccination and improve vaccination beliefs and intentions. Future campaigns should consider the beliefs and information needs of target populations in their design. Findings were inconclusive whether the medium through which the message was delivered, e.g. text message, affected outcomes. More high quality research is needed to demonstrate the behavioural outcomes of messaging interventions.
Original languageEnglish
PublisherPsyArXiv Preprints
Number of pages76
Publication statusEarly online date - 16 Dec 2020


  • vaccines
  • vaccine hesitancy
  • behaviour change
  • health psychology
  • systematic review
  • epidemics
  • public health messaging
  • vaccine uptake
  • pandemics


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