Text message reminders improved uptake of second dose of flu vaccine

VANCOUVER, British Columbia — Use of text message reminders to help promote delivery of a second dose of influenza vaccine in a low-income, urban minority population could be improved by embedding health literacy information into the message, according to study findings presented here.

Melissa S. Stockwell, MD, MPH, assistant professor of population and family health at Columbia’s Mailman School of Public Health and pediatrics at Columbia College of Physicians and Surgeons, and colleagues evaluated 660 families of children aged 6 months to 8 years to determine if embedding health literacy information in text message vaccine reminders improved receipt and timeliness of the second dose of influenza vaccine among underserved children in need of two doses. Families were enrolled during the 2012-2013 influenza season if a child was in need of a second dose.

Melissa S. Stockwell

“Influenza vaccine coverage is low, especially among low-income, minority populations,” Stockwell said during a presentation here at the 2014 Pediatric Academic Societies Annual Meeting. “Young children in need of two doses in a given season are at particular risk, with less than half receiving both needed doses. We recently demonstrated the impact of text message influenza vaccine reminders for receipt of a first influenza vaccine dose, but little is known about what types of messages are most effective in promoting receipt of a needed second dose.”

Participants were randomized into “health literacy” text message, “conventional” text message and “written reminder only.” A written reminder with the next dose due date was given to all participants at enrollment. Automated, personalized text messages were also sent to participants in the text messaging arms on days 7, 21, 25, 28, and 42 after the first influenza vaccine dose. Second-dose due date and clinic walk-in hours were included in conventional messages and health literacy messages. However, health literacy messages also contained information about why two doses are needed, including an interactive message that allowed parents to request further information.

Overall, 88% of participants were Latino and 96% were publicly-insured.

The health literacy text message group was more likely (72.7%) to receive a second dose compared with the conventional text message group (66.7%) and written reminder only group (57.7%; P=.003).

Forty-four percent of the health literacy text message group received the second dose of the influenza vaccine by day 42 compared with 32.4% of the conventional text message group and 26.5% of the written reminder only group (P=.001).

“Among young, low-income urban children, the addition of text message reminder was associated with increased receipt and timeliness of a second dose of flu vaccine and in adding educational information, we did see effectiveness, particularly in getting the vaccine in a more timely fashion,” Stockwell said. — by Amber Cox

For more information:

Stockwell MS. Abstract 3560.1. Presented at: PAS 2014; May 2-6, 2014; Vancouver, British Columbia.

Disclosure: This study was funded by the NIH. The researchers report no relevant financial disclosures.