Electronic messaging increases flu vaccine uptake in younger adults with chronic diseases

Influenza vaccination rates remain suboptimal among young and middle-aged patients with chronic diseases, despite strong recommendations in guideline from worldwide public health authorities. Effective methods to increase influenza vaccination in this population are needed. As a possible strategy to improve influenza vaccination rates, Danish investigators examined whether electronically delivered letters (“nudges”) could increase influenza vaccination uptake among patients aged 18–64 years with chronic diseases. Using nationwide administrative health registries, investigators enrolled all Danish citizens aged 18-to-64 years who met the criteria for free-of-charge influenza vaccination because of preexisting chronic diseases. The study, conducted between September 24, 2023, and May 31, 2024, randomized patients to no letter (usual care) or six different behaviourally informed electronic letters.Results showed the following:A total of 299,881 participants (53.2% female, median age, 52.0 years) were randomized. Compared with usual care, influenza vaccination rates were higher among those receiving any of the six electronically-sent intervention letters (any intervention letter, 39.6% vs usual care, 27.9%; difference, 11.7 percentage points; 99.29% CI, 11.2–12.2 percentage points; p < 0.001). Each type of individual electronic letter significantly increased influenza vaccination rate. The largest effect sizes were seen with a repeated letter sent 10 days after the initial letter (repeated letter, 41.8% vs usual care, 27.9%; difference, 13.9 percentage points; 99.29% CI, 13.1–14.7 percentage points; p < 0.001) and with a letter emphasizing the potential cardiovascular benefits of vaccination (cardiovascular gain letter, 39.8% vs usual care, 27.9%; difference, 11.9 percentage points; 99.29% CI, 11.1–12.7 percentage points; p < 0.001). The authors conclude that in this nationwide study, electronically delivered letter-based nudges markedly increased influenza vaccination rates compared with usual care among young and middle-aged patients with chronic diseases. The best effects were seen with a repeated letter strategy, where a standard informational letter was sent twice (10 days apart) and when a letter highlighted the potential benefits of influenza vaccination on cardiovascular health. The results of this study suggest that a simple, scalable and cost-efficient electronic letter strategy may be used to encourage positive health behaviour among young and middle-aged patients with chronic diseases, resulting in substantial public health benefits.Reference:Johansen ND, Vaduganathan M, Bhatt AS, et al. Electronic nudges to increase influenza vaccination in patients with chronic diseases. A randomized clinical trial. JAMA 2024. Published online October 11, 2024. (accessed October 15, 2024).

Electronic messaging increases flu vaccine uptake in younger adults with chronic diseases

Register for free access or login.

Related Topics