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24-04-2012 | General practice | Article

Text messaging intervention helps improve influenza vaccination rates


Free abstract

MedWire News: Text messaging reminders help improve uptake of the influenza vaccination in children and adolescents from low-income areas, suggest study findings.

"Timely vaccination is the cornerstone of influenza prevention through vaccination of susceptible populations before illness becomes epidemic in communities," explain Melissa Stockwell (Columbia University, New York, USA) and colleagues.

This is particularly important in children and adolescents, who are at increased risk for hospitalization from influenza compared with the general population.

In addition, lower income populations are at higher risk from influenza as they generally live in more crowded conditions and also have the lowest uptake of vaccination.

As traditional (mail or telephone) reminders are known to be ineffective in this section of the population, Stockwell and team assessed whether text messaging could be a more useful method of reminding parents or carers about influenza vaccinations.

Writing in JAMA, the researchers report the results of a trial involving 9213 children and adolescents (aged 6 months to 18 years) from low-income families receiving general medical care at four community-based clinics in the USA through 2010-2011.

Concentrating on the influenza season (November 2010 to March 2011), the investigators included 7574 children who had not received the influenza vaccination at the beginning of the season. These children were randomly assigned to receive a text messaging intervention (n=3790) or usual care (n=3784).

Both the intervention and usual care families received an automated telephone reminder about the value of vaccination and the potential severity of influenza infection.

The text message intervention group also received five personalized text message vaccination reminders over the course of a week in either English or Spanish. The first three messages provided educational info about the value of vaccination, and the last two gave information about possible appointment dates for local Saturday vaccination clinics.

At the end of the influenza season, the authors found that 43.6% of the intervention versus 39.9% of the usual care group had been vaccinated, corresponding to a significant between-group difference.

The researchers say that whilst influenza vaccine uptake remains relatively low, text messages have the potential to "reach large populations."

They "may also be cost-effective," add Stockwell and co-workers. "Once the system is set up, the only variable cost is the sending of the text messages, which, even using commercial platforms, usually cost pennies per message.

"Therefore, depending on the size of the population, even amortizing upfront and monitoring costs, text messaging is inexpensive on a per individual basis."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Helen Albert

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