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Vaccination Programs: Special Supplemental Nutrition Program for Women, Infants & Children (WIC) Settings


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a Community Guide systematic review completed in 2009 pdf icon [PDF - 466 KB] (15 studies, search period January 1980-November 2009). A more recent search for evidence (search period 2009-February 2012) did not identify any new studies to be included in the systematic review.

This review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice and policy related to increasing appropriate vaccination.

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 504 KB].

The systematic review included 15 studies.

  • Overall, vaccination rates among children increased by a median of 10.5 percentage points (8 studies with 10 study arms).
  • One study evaluated the use of interventions used alone and found no effect.
  • The additional interventions most often used were monthly voucher pickup (5 studies) and vaccine administration on-site or in collocated healthcare facilities (4 studies).

Summary of Economic Evidence

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 504 KB].

The economic evidence is based on three studies that looked at the childhood vaccination series (search period 1980–2012). Monetary values are presented in 2013 U.S. dollars.

  • Intervention cost per child per year averaged $17.77. The cost per vaccinated child averaged $67.96 (2 studies).
    • Cost estimates varied because interventions were for monthly voucher pickup programs that used different referral types or included additional monitoring.
  • The third study provided an incomplete estimate for intervention cost, reporting only the cost of assessment for age-appropriate vaccination status (range: $1.90 to $3.93). The higher cost was attributed to the addition of an on-site nurse.


The CPSTF finding should be applicable to most WIC settings and populations.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • How effectiveness are intervention when implemented alone?
  • What are the effects of collocating WIC and health care services, requiring monthly voucher pickup, or providing WIC interventions outside of the medical home?

Study Characteristics

  • All of the included studies evaluated WIC programs in urban settings and populations.