Text messages prompting people to get their flu shot

Only about half of kids ages 6 months to 17 years received the flu shot in the 2010-2011 season, which may be one reason influenza remains one of the most common causes of hospitalization among kids today, according to a study in this week's issue of the Journal of the American Medical Association.

So researchers from Columbia University and beyond tested an intervention program on a randomized control trial of more than 9,000 kids of that same age range at four community-based clinics in the United States, where more than 7,500 kids had not received the vaccine prior to starting the intervention.

They found that, by late March of 2012, text messaging helped to modestly increase the vaccination rate from 39.9 percent in the "usual care" group to 43.6 percent in the group that received text message reminders.

For this study, both the intervention and usual care groups received the same standard care, as well as an automated telephone reminder flyers posted at the study sites. The parents of children assigned to the intervention, however, got as many as five weekly immunization registry-linked text messages that provided info about Saturday clinics.

"Traditional vaccine reminders have had a limited effect on low-income populations; however, text messaging is a novel, scalable approach to promote influenza vaccination," the authors write.

More than half of the kids in the study come from Spanish-speaking homes, and 88 percent are publicly insured. The authors note that vaccination rates tend to be lower in low-income populations, which also tend to be more susceptible to flu outbreaks due to more crowded living conditions.

"For vaccines like influenza, recommended for the majority of the population, even small increases in vaccination rates can lead to large numbers of protected individuals," they write. "It may also be cost-effective. 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."

Lead author Melissa Stockwell of Columbia tells Reuters Health that the intervention system they used cost $7,000 to build, $270 a week to monitor, and $165 to actually send the 23,000-plus messages: "If you're a big enough organization, the up-front cost isn't that big of a deal."

Although the flu vaccination rate remained lower in this population than the 50 percent rate across the country, even with the text-messaging campaign, researchers say the increase, applied across the country, could result in 2.5 million more children being vaccinated a year.

The Centers for Disease Control suggests that everyone older than 6 months get the flu shot every year; not only does the vaccine lead to great protection from serious illness, but universal vaccination would also result in fewer deaths among the most vulnerable -- namely infants and the elderly.