tetano
Editor, Senior Moderator
Vaccine
. 2025 Jul 9:62:127477.
doi: 10.1016/j.vaccine.2025.127477. Online ahead of print. Randomised controlled trials of behavioural nudges delivered through text messages to increase influenza and COVID-19 vaccine uptake among pregnant women (EPIC study) in Australia
Prabha H Andraweera[SUP] 1 [/SUP], Bing Wang[SUP] 2 [/SUP], Margie Danchin[SUP] 3 [/SUP], Christopher C Blyth[SUP] 4 [/SUP], Ivo Vlaev[SUP] 5 [/SUP], Jason J Ong[SUP] 6 [/SUP], Jodie Dodd[SUP] 7 [/SUP], Jennifer Couper[SUP] 8 [/SUP], Thomas R Sullivan[SUP] 9 [/SUP], Alana R Cuthbert[SUP] 9 [/SUP], Jonathan Karnon[SUP] 10 [/SUP], Nicola Spurrier[SUP] 11 [/SUP], Michael Cusack[SUP] 12 [/SUP], Dylan Mordaunt[SUP] 13 [/SUP], Dimi Simatos[SUP] 14 [/SUP], Gus Dekker[SUP] 15 [/SUP], Samantha Carlson[SUP] 16 [/SUP], Jane Tuckerman[SUP] 17 [/SUP], Nicholas Wood[SUP] 18 [/SUP], Lisa Whop[SUP] 19 [/SUP], Joanne Koch[SUP] 20 [/SUP], Kirsty Herewane[SUP] 21 [/SUP], Deborah Pidd[SUP] 22 [/SUP], Ashleigh Rak[SUP] 3 [/SUP], Helen S Marshall[SUP] 2 [/SUP]
Affiliations
Background: Influenza and COVID-19 vaccine uptake among pregnant women is sub-optimal. We assessed the effectiveness of a multi-component behavioural nudge intervention to improve COVID-19 and influenza vaccine uptake among pregnant women.
Methods: A 'nudge' was developed that comprised three SMS text message reminders with a social norming message, links to vaccine safety information, videos of health professionals and consumers recommending vaccination in pregnancy and a pledge to get vaccinated. In separate RCTs, pregnant women who had not received an influenza vaccine during the 2023 influenza season, or received ≤2 doses of a COVID-19 vaccine, were randomised (1:1) to standard care or intervention at four hospitals in Australia.
Results: A total of 1090 and 1068 pregnant women were randomised to the COVID-19 and influenza RCTs, respectively. The nudges resulted in a 1.6 % increase in COVID-19 vaccine uptake and 1.7 % increase in influenza vaccine uptake among pregnant women. However, there was no significant difference in the percentage of pregnant women in the intervention (2.7 %) and the standard care (1.1 %) groups receiving one dose of a COVID-19 vaccine from randomisation until delivery (odds ratio, 2.40; 95 % confidence interval [CI], 0.91 to 6.30, P = 0.08). Similarly, there was no significant difference in the percentage of pregnant women in the intervention (58.0 %) and the standard care (56.3 %) groups receiving the influenza vaccine from the time of randomisation until delivery (odds ratio, 1.07; 95 % CI, 0.84 to 1.38, P = 0.58). Less than 2 % of women had viewed the video content of the nudges in both RCTs.
Conclusions: The nudges delivered via SMS resulted in small increases in COVID-19 and influenza vaccination uptake among pregnant women. Considering the very low cost of bulk SMS, these nudges may be cost-effective interventions at a population level.
Keywords: Behavioural nudge; COVID-19; Influenza; Pregnant; Vaccine.
. 2025 Jul 9:62:127477.
doi: 10.1016/j.vaccine.2025.127477. Online ahead of print. Randomised controlled trials of behavioural nudges delivered through text messages to increase influenza and COVID-19 vaccine uptake among pregnant women (EPIC study) in Australia
Prabha H Andraweera[SUP] 1 [/SUP], Bing Wang[SUP] 2 [/SUP], Margie Danchin[SUP] 3 [/SUP], Christopher C Blyth[SUP] 4 [/SUP], Ivo Vlaev[SUP] 5 [/SUP], Jason J Ong[SUP] 6 [/SUP], Jodie Dodd[SUP] 7 [/SUP], Jennifer Couper[SUP] 8 [/SUP], Thomas R Sullivan[SUP] 9 [/SUP], Alana R Cuthbert[SUP] 9 [/SUP], Jonathan Karnon[SUP] 10 [/SUP], Nicola Spurrier[SUP] 11 [/SUP], Michael Cusack[SUP] 12 [/SUP], Dylan Mordaunt[SUP] 13 [/SUP], Dimi Simatos[SUP] 14 [/SUP], Gus Dekker[SUP] 15 [/SUP], Samantha Carlson[SUP] 16 [/SUP], Jane Tuckerman[SUP] 17 [/SUP], Nicholas Wood[SUP] 18 [/SUP], Lisa Whop[SUP] 19 [/SUP], Joanne Koch[SUP] 20 [/SUP], Kirsty Herewane[SUP] 21 [/SUP], Deborah Pidd[SUP] 22 [/SUP], Ashleigh Rak[SUP] 3 [/SUP], Helen S Marshall[SUP] 2 [/SUP]
Affiliations
- PMID: 40639178
- DOI: 10.1016/j.vaccine.2025.127477
Background: Influenza and COVID-19 vaccine uptake among pregnant women is sub-optimal. We assessed the effectiveness of a multi-component behavioural nudge intervention to improve COVID-19 and influenza vaccine uptake among pregnant women.
Methods: A 'nudge' was developed that comprised three SMS text message reminders with a social norming message, links to vaccine safety information, videos of health professionals and consumers recommending vaccination in pregnancy and a pledge to get vaccinated. In separate RCTs, pregnant women who had not received an influenza vaccine during the 2023 influenza season, or received ≤2 doses of a COVID-19 vaccine, were randomised (1:1) to standard care or intervention at four hospitals in Australia.
Results: A total of 1090 and 1068 pregnant women were randomised to the COVID-19 and influenza RCTs, respectively. The nudges resulted in a 1.6 % increase in COVID-19 vaccine uptake and 1.7 % increase in influenza vaccine uptake among pregnant women. However, there was no significant difference in the percentage of pregnant women in the intervention (2.7 %) and the standard care (1.1 %) groups receiving one dose of a COVID-19 vaccine from randomisation until delivery (odds ratio, 2.40; 95 % confidence interval [CI], 0.91 to 6.30, P = 0.08). Similarly, there was no significant difference in the percentage of pregnant women in the intervention (58.0 %) and the standard care (56.3 %) groups receiving the influenza vaccine from the time of randomisation until delivery (odds ratio, 1.07; 95 % CI, 0.84 to 1.38, P = 0.58). Less than 2 % of women had viewed the video content of the nudges in both RCTs.
Conclusions: The nudges delivered via SMS resulted in small increases in COVID-19 and influenza vaccination uptake among pregnant women. Considering the very low cost of bulk SMS, these nudges may be cost-effective interventions at a population level.
Keywords: Behavioural nudge; COVID-19; Influenza; Pregnant; Vaccine.