Randomized Controlled Trial of Text Message Reminders for Increasing Influenza Vaccination

Abstract

PURPOSE Seasonal influenza vaccine is recommended and funded for groups at higher risk of serious infection, but uptake is suboptimal. We conducted a randomized controlled trial of short message service (SMS) reminders for influenza vaccination.METHODS Six weeks after seasonal influenza vaccinations began, we identified high-risk patients who had a mobile telephone number on record at 10 practices in Western Australia. Thirty-two percent of the selected patients had already been vaccinated in the current year and were ineligible. Of the remaining 12,354 eligible patients at each practice one-half were randomly assigned to receive a vaccination reminder by SMS (intervention) and the rest received no SMS (control). Approximately 3 months after the SMS was sent (the study period), vaccination data were extracted from the patients' electronic medical records. Log-binomial regression models were used to calculate the relative risk (RR) of vaccination between the intervention and control group. RESULTSTwelve-percent (769 of 6,177) of the intervention group and 9% (548 of 6,177) of the control group were vaccinated during the study period, a 39% relative increase attributable to the SMS (RR = 1.39; 95% CI, 1.26-1.54). For every 29 SMSs sent, costing $3.48, 1 additional high-risk patient was immunized. The greatest effect was observed for children younger than 5 years, whose parents were more than twice as likely to have their child vaccinated if they received a SMS reminder (RR = 2.43; 95% CI, 1.79-3.29).CONCLUSION We found SMS reminders to be a modestly effective, low-cost means to increase seasonal influenza vaccine coverage among high-risk patients. 2017;15:507-514. https://doi.org/10.1370/afm.2120. Ann Fam Med INTRODUCTIONI nfluenza is associated with major morbidity and mortality.1 It is estimated that globally 3 to 5 million cases of severe illness and 300,000 to 500,000 deaths can be attributed to influenza infection each year.1 Individuals aged 65 years or older and children aged 5 years or younger, those with chronic medical conditions (eg, asthma, chronic heart disease, diabetes), and pregnant women are most at increased risk of serious influenza illness.2 In Australia, seasonal influenza vaccination is provided at no cost for these high-risk groups, as well as for persons who are Aboriginal and/or Torres Strait Islander (ie, Indigenous Australians).3 Despite a clear recommendation for annual seasonal influenza vaccination and the provision of government-purchased vaccine, seasonal influenza vaccine uptake has been poor among many high-risk groups. [4][5][6][7][8][9] The latest data from the Australian Institute of Health and Welfare indicate that, although 75% of adults aged 65 years or older received a seasonal influenza vaccine, only 36% of other high-risk populations are vaccinated.10 Strategies are needed to improve the uptake of seasonal influenza vaccines in these patient populations.Prior research has shown that expanded access to influenza vaccines, standing orders, provider feedback and ince...

Harnessing the power of advocacy to improve seasonal influenza vaccination coverage in the Eastern Mediterranean Region

“…In resource-limited settings, advocacy through social media, short message service (SMS) or emails are alternative, low-cost means of improving vaccination rates through sharing educational information or reminders for vaccination. A randomized controlled trial found that influenza vaccine coverage among highrisk patients assigned to receive an SMS vaccination reminder showed improved vaccination rates compared with the control group (18). Similar findings were reported for high-risk general practice patients in the United Kingdom and among pregnant women in New York city who received SMS vaccine reminders (19,20).…”

Harnessing the power of advocacy to improve seasonal influenza vaccination coverage in the Eastern Mediterranean Region

“…In resource-limited settings, advocacy through social media, short message service (SMS) or e-mails is an alternative, low-cost means of improving vaccination rates through sharing educational information or reminders for vaccination. A randomized controlled trial found that influenza vaccine coverage among high-risk patients assigned to receive an SMS reminder improved compared with the control group (18). Similar findings were reported for high-risk general practice patients in the United Kingdom of Great Britain and Northern Ireland and among pregnant women in New York City who received SMS vaccine reminders (19,20).…”

The role of health determinants in the influenza vaccination uptake among older adults (65+): a scope review

“…The study designs are divided into 34 cross-sectional studies of which 13 studies were developed by means of a secondary analysis of already existing data [11, 12, 14, 15, 19-21, 28-30, 38, 39, 41] and two cross-sectional studies following a qualitative study design [26,32], four randomized controlled trials [43][44][45][46], two systematic reviews [47,48], two cohort studies [49,50] and two theoretical reviews [51,52].…”