Text Messaging Is a Good Tool for Appointment Reminders


Text messaging appointment reminders led to more flu shots among low-income pregnant women, researchers found.

The cell phone texts were especially useful in increasing influenza vaccine compliance among women early in their third trimester, the study of 1,187 obstetric patients showed.

Researchers enrolled the women into the study during the 2011 flu season from 5 community-based clinics in New York City. Everyone received the standard automated telephone appointment reminders. The intervention group also received 5 weekly text messages from mid-September through December. In addition, the intervention group was sent 2 text message appointment reminders. 

Pertinent Points:

- Text messaging may be a way to increase the number of low-income women getting influenza vaccinations, a study of 1,187 pregnant women showed.

- The study, conducted in New York City during the 2011 influenza season, showed that the text messages were particularly effective in vaccinating women who were early in their third trimester.

The randomized controlled trial, published in a supplement to the American Journal of Public Health, showed that women who received the texts were 30% more likely to be vaccinated as of December 2011 (adjusted odds ratio [AOR], 1.30; 95% confidence interval [CI]: 1.003, 1.69; end of September: AOR, 1.34; 95% CI: 0.98, 1.85; October: AOR = 1.35; 95% CI: 1.05, 1.75; November: AOR, 1.27; 95% CI: 0.98, 1.65).

The results were even more striking among women early in their third trimester, with 62% of those getting the text messages being vaccinated compared with 49% in the control group that only received the standard phone reminders.

The authors noted the use of vaccine text messaging has been limited but that previous studies have also shown that vaccine reminder-recalls have improved flu vaccination rates in both the pediatric and adolescent populations.

The study was conducted by Columbia University's Mailman School of Public Health and led by Dr. Melissa Stockwell, an assistant professor of pediatrics at Columbia and a physician at NewYork-Presbyterian Hospital.

"Vaccination during pregnancy helps to protect newborns," Stockwell said in a release. "To achieve protection before influenza begins circulating in the community, we strongly recommend that women receive influenza vaccination during pregnancy and as soon as the vaccine becomes available in the fall."


Stockwell MS, Westhoff C, Kharbanda EO, et al. Influenza vaccine text message reminders for urban, low-income pregnant women: a randomized controlled trial. Am J Public Health. 2014;104(suppl 1):e7-e12.

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