research summary

Text Message Reminders Increase Pediatric Influenza Vaccinations

Leigh Precopio

Text message reminders were an effective intervention to increase the receipt and timeliness of a second dose of the influenza vaccine among pediatric patients when compared with usual care, according to the results of a randomized controlled trial.

Researchers utilized data from 50 pediatric primary care offices from 24 states as part of the American Academy of Pediatrics’ Pediatric Research in Office Settings network. The 2017-2018 and 2018-2019 influenza seasons were examined. Included were 2086 caregiver-child dyads. All children were aged 6 months to 8 years and needed a second dose of the influenza vaccine that season.

After stratification for age and language, all participants were randomized to receive the intervention or usual care. Caregivers in the intervention group received automated, personalized text message reminders which included interactive educational information. The primary outcome was receipt of the second dose by season end, defined here as April 30th. The secondary outcome of timeliness was measured by receipt of the second dose by day 42 (representing 2 weeks after the second dose due date) and time elapsed from first to second doses.

Children in the intervention group were more likely to receive a second dose by season end than children in the usual care group (83.8% vs 80.9%, respectively; adjusted risk difference [ARD] = 3.8%; [95% CI, 0.1-7.5]). The intervention group was also more likely to receive a second dose by day 42 (62.4% vs 55.7%; ARD = 8.3%; [95% CI, 3.6-13.0]).

Further, the researchers noted that the intervention had greater effect on practices that had walk-in vaccine hours vs those who primarily schedule appointments. Preferred text languages was not an effect modifier, as the intervention produced similar results for both English and Spanish speakers. However, more timely vaccination was seen in patients who were commercially insured vs publicly insured.

The researchers note this study may not be representative of a larger population, as all included patients agreed to participate.

“In this large-scale trial in practices across the country, we demonstrated the effectiveness of using personalized text message reminders to increase overall receipt and the timeliness of the second dose of the influenza vaccine,” the researchers concluded. “A next step would be to assess how text message reminders for the second dose of influenza vaccine could be broadly implemented in practice settings serving children.”



Stockwell MS, Shone LP, Nekrasova E. Text message reminders for the second dose of influenza vaccine for children: an RCT. Pediatrics. 2022;150(3):e3033056967. doi:10.1542/peds.2022-056967.