Influenza
Conditions
Keywords
Influenza, text message, vaccination
Brief summary
Influenza remains a potentially significant and largely preventable source of morbidity and mortality, yet vaccine coverage is low. Young children are at particular risk for underimmunization because they may need to receive 2 doses in a current season. Even among those young children that initiate vaccination, only 40% receive the important second dose, yet one dose does not confer adequate protection. Low-income, urban children may be at particular risk of not receiving two doses. While traditional mail and phone immunization reminders notifying families that a vaccine is due have had limited efficacy in low-income, urban populations, we have demonstrated the success of using text messages. Comparing the effectiveness of different forms of reminders on receipt of this critical second dose of influenza vaccine has not been studied. Besides failure to remember to return for subsequent doses, receipt of 2 doses of influenza vaccine in a season can be affected by limited health literacy regarding influenza vaccination, particularly associated with understanding the need for a second dose since not all children require it. Text messaging offers the ability to combine health literacy promoting information and reminders in a scalable, efficient manner for populations at high risk for underimmunization, limited health literacy, and influenza spread. Therefore, the purpose of this study is to determine whether the provision of interactive vaccine health literacy-promoting information in text message vaccine reminders improves receipt and timeliness of the second dose of influenza vaccine within a season for underserved children in need of two doses.
Interventions
OTHERText Message
OTHERWritten reminder
Sponsors
Columbia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
6 Months to 9 Years
Healthy volunteers
No
Inclusion criteria
* Parenting adult of child age 6 months through 8 years * Child receives care at study site (visit in last 12 mths) * child received influenza vaccine and needs a second this season * Parent has cell phone has text message capability * Parent speak English or Spanish * Can read text messages
Exclusion criteria
* Parent does not speak English or Spanish * Parent does not have cell phone with text messages
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Receipt of 2nd Dose of the Influenza Vaccine. | by April 30th after receipt of first dose (up to 8 months) |
Secondary
| Measure | Time frame |
|---|---|
| Number of Subjects Who Receive the 2nd Dose of the Influenza Vaccine on Time. | by 42 days after dose of first vaccination |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Educational Text Message Educational text message reminder
Text Message
Written reminder | 216 |
| Plain Text Message plain text message reminder
Text Message
Written reminder | 225 |
| Written Reminder Only written reminder at time of vaccination
Written reminder | 219 |
| Total | 660 |
Baseline characteristics
| Characteristic | Educational Text Message | Plain Text Message | Written Reminder Only | Total |
|---|---|---|---|---|
| Age, Categorical <=18 years | 216 Participants | 225 Participants | 219 Participants | 660 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Region of Enrollment United States | 216 participants | 225 participants | 219 participants | 660 participants |
| Sex: Female, Male Female | 105 Participants | 108 Participants | 114 Participants | 327 Participants |
| Sex: Female, Male Male | 111 Participants | 117 Participants | 105 Participants | 333 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 0 / 216 | 0 / 225 | 0 / 219 |
| serious Total, serious adverse events | 0 / 216 | 0 / 225 | 0 / 219 |
Outcome results
Primary
Receipt of 2nd Dose of the Influenza Vaccine.
Time frame: by April 30th after receipt of first dose (up to 8 months)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Educational Text Message | Receipt of 2nd Dose of the Influenza Vaccine. | 72.7 percentage of participants |
| Plain Text Message | Receipt of 2nd Dose of the Influenza Vaccine. | 66.7 percentage of participants |
| Written Reminder Only | Receipt of 2nd Dose of the Influenza Vaccine. | 57.1 percentage of participants |
Secondary
Number of Subjects Who Receive the 2nd Dose of the Influenza Vaccine on Time.
Time frame: by 42 days after dose of first vaccination
Population: One patient in the plain text message arm was removed for this analysis because they received the second dose too early and was not re-vaccinated
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Educational Text Message | Number of Subjects Who Receive the 2nd Dose of the Influenza Vaccine on Time. | 43.5 percentage of participants |
| Plain Text Message | Number of Subjects Who Receive the 2nd Dose of the Influenza Vaccine on Time. | 33.9 percentage of participants |
| Written Reminder Only | Number of Subjects Who Receive the 2nd Dose of the Influenza Vaccine on Time. | 25.6 percentage of participants |