“Text messaging can be a very effective tool for reaching large numbers of people in need of vaccination, whether they are children or adults,” says lead author Melissa Stockwell, MD, MPH, assistant professor of Pediatrics and Population and Family Health at the Columbia University College of Physicans and Surgeons and Columbia’s Mailman School of Public Health. “Even small increases in the flu vaccination rates can lead to large numbers of protected individuals.”
The researchers focused on hard-to-reach, low-income, urban children and adolescents. “This group is at increased risk for influenza due to crowded living situations. The traditional method of using phone or mailed reminders has done little to improve low vaccination rates,” says Dr. Stockwell, who is also a pediatrician at NewYork-Presbyterian Hospital.
The randomized, controlled study followed 9,213 children and adolescents ages 6 months to 18 years who were receiving care at four community-based clinics in Upper Manhattan during the 2010-2011 flu season. A total of 7,574 had not received a flu vaccine prior to the intervention start date and were included in the analysis. The children and adolescents in the study were primarily minority, 88% were publicly insured, and 58% were from Spanish-speaking families.
Parents of children assigned to the text-message intervention received up to five weekly texts providing educational information and instructions on where the vaccinations were administered. Everyone in the study received the usual care, an automated telephone reminder, and access to informational flyers posted at the study sites.
As of March 31, 2011, a higher proportion of children and adolescents in the intervention group (43.6%) compared with the usual care group (39.9%) received the influenza vaccine. As of the Fall 2010, 27.1% of the text-message group vs. 22.8% of the usual care group had received the vaccine.
Vaccination coverage overall remained low, as it does nationally. The researchers recommend further studies to identify ways to maximize the potential of text messaging.
The study was supported by a grant from the Maternal and Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services (R40 MC17169).
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