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Text Reminders to Get Flu Shot Could Work for COVID-19 Too

Editor’s observe: Discover the most recent COVID-19 information and steerage in Medscape’s Coronavirus Resource Center.

When individuals with an upcoming physician’s appointment get a textual content reminder about receiving a flu vaccination, it will increase the probability that they may get immunized once they are available in, notably if the message states the shot is “reserved” for them, new proof reveals.

“Our take dwelling message is that textual content message reminders are efficient for growing vaccination uptake — and the most effective ones talk to sufferers {that a} vaccine is reserved for you,” stated Dena M. Gromet, PhD.

“This technique capitalizes on a well-studied behavioral science phenomenon: A reserved vaccine feels prefer it belongs to you, so it seems like a loss to offer it up,” added Gromet, government director of Habits Change for Good Initiative on the College of Pennsylvania in Philadelphia.

The study was revealed on-line April 29 in PNAS.

Might Work for COVID-19

The researchers targeted on which message ways labored greatest for major care workplaces providing the flu vaccine — however the technique additionally may apply to COVID-19 vaccinations, a research creator and different specialists stated.

“Though uptake of the COVID-19 vaccine comes with a singular set of challenges,” Gromet stated, “we count on that for many who are open to getting vaccinated however have not adopted via, all these reminders will probably be an efficient nudge towards vaccination.”

It’s a “very attention-grabbing research with vital implications for reinforcing vaccination charges, resembling for COVID-19,” David Kaelber, MD, instructed Medscape Medical Information when requested to remark.  



Dr David Kaelber

“I might count on the same impact if this technique had been utilized to COVID-19 vaccinations as properly,” added Kaelber, professor of Inside Drugs, Pediatrics, and Inhabitants and Quantitative Well being Sciences at Case Western Reserve College in Cleveland, Ohio.



Dr Julie C. Jacobson Vann

Together with lead creator Katherine Milkman, PhD, and colleagues, Gromet studied 19 attainable textual content message scripts, mixtures, and timing to extend uptake of vaccination. They in contrast vaccination charges amongst messages despatched to 37,304 sufferers at two establishments versus individuals who didn’t obtain such reminders.

Primarily based on different analysis, “this appears to be an affordable method to additionally enhance vaccination charges for COVID-19,” Julie C. Jacobson Vann, PhD, MS, RN, from the College of North Carolina at Chapel Hill College of Nursing, stated in an e-mail.

Stick With Your Type

Along with a larger obligation to observe via once they imagine a vaccine is reserved for them, sufferers additionally responded greatest to textual content messages alongside the traces of typical communications from their physician’s workplace.

In different phrases, it’s best to keep away from attempting to be notably artistic or humorous.

“We had been stunned to seek out in our post-hoc analyses that extra interactive and casual messages didn’t carry out as properly,” Gromet stated. “In truth, a few of our most intelligent interventions had been among the many least efficient.”

A message with an image of a canine telling a cat a joke about spreading the flu, for instance, didn’t work notably properly.

A Messaging “Megastudy”

Gromet and colleagues carried out a megastudy, a subject experiment the place totally different groups of scientists check a number of interventions in the identical inhabitants and on the identical end result. On this case, they assessed 47,306 sufferers coming to Penn Drugs or Geisinger Well being for a brand new or routine major care appointment within the fall 2020.

They randomly assigned sufferers to one of many 19 textual content messaging methods or to the management group. None had obtained a flu shot already, in accordance with their digital well being file.

Common age was 52 years, 43% had been male, and 70% had been white. Though digital well being data indicated that not one of the sufferers had but obtained a flu shot, 47% had obtained one throughout the earlier flu season.

“I believe many people have a way that automated texting/messaging about immunizations exterior of or together with an in-person go to ought to enhance immunization charges some,” Kaelber stated. “What’s nice about this research is that it appears to be like at many alternative methods to do that and subsequently is prescriptive about methods to textual content/message which might be kind of efficient.”

Clinically Efficient and Price-effective?

All 19 textual content messaging methods elevated vaccination charges by a mean 2.1 proportion factors. “Though the typical 2.1 proportion level distinction in influenza vaccination charges between the textual content message contributors and comparability contributors is small, the general impact has the potential to be substantial if utilized to massive populations,” Jacobson Vann stated.

The best method was a two-pronged method: One message despatched 72 hours earlier than an appointment noting that “it is flu season,” “a flu vaccine is offered for you,” and “a vaccine reminder” could be despatched earlier than the appointment. A second textual content despatched 24 hours upfront merely said that “it is a reminder {that a} flu vaccine has been reserved on your appointment.”

This intervention was related to a 4.6 proportion level enhance in vaccination at the price of sending two textual content messages, or lower than 10 cents, the researchers observe.

The investigators additionally calculated a extra conservative estimate and located this technique related to a 2.eight proportion level enhance in vaccination, or a 6.7% enhance. 

“Though a 6.7% enchancment in vaccination charges may not seem to be an excessive amount of, on the inhabitants degree, contemplating everybody who ought to obtain a vaccine just like the influenza vaccine or the COVID-19 vaccine, this enhance in vaccination charges will lead to tens of millions and tens of millions of extra individuals being vaccinated,” Kaelber stated.

Subsequent Steps

Gromet and colleagues additionally carried out the same research with Walmart pharmacy sufferers. Preliminary findings embrace the same top-performing message that the flu vaccine was “ready for you.”

“We’re longing for alternatives to check messages particularly for COVID-19 vaccinations and to look at different forms of nudges that would assist encourage vaccination,” Gromet added.

PNAS. Printed on-line April 29, 2021. Full text

Gromet, Kaelber, and Jacobson Vann disclosed no related monetary relationships. The Nationwide Institute on Growing older, the Invoice and Melinda Gates Basis, the Flu Lab, and the Penn Heart for Precision Drugs Accelerator Fund supported the research. The AKO Basis, John Alexander, Mark J. Leder, and Warren G. Lichtenstein supplied further help.

Damian McNamara is a employees journalist primarily based in Miami. He covers a variety of medical specialties, together with infectious ailments, gastroenterology, and demanding care. Comply with Damian on Twitter: @MedReporter.

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