A megastudy of text-based nudges encouraging patients to get vaccinated at an upcoming doctor’s appointment

TLDR

Many Americans miss life‑saving vaccines annually, and the COVID‑19 vaccine’s availability heightens the urgency to promote vaccination. The study tests 19 text‑message nudges in a large field experiment (N = 47,306) to increase influenza vaccination uptake. The experiment delivered 19 text‑message nudges to patients before primary‑care visits, measuring their effect on influenza vaccination. Text messages sent before a primary‑care visit raised vaccination rates by about 5 %; the most effective nudge reminded patients twice that a flu shot was reserved for them, and such scripts could be adapted for other life‑saving vaccines, including COVID‑19.

Abstract

Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment ( N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor’s appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.