Related Experiment Video
Updated: Aug 13, 2025
Use of an Influenza Antigen Microarray to Measure the Breadth of Serum Antibodies Across Virus Subtypes
Published on: July 26, 2019
Can uptake of childhood influenza immunisation through schools and GP practices be increased through
Rebecca Howell-Jones1, Natalie Gold2,3,4, Sarah Bowen1,5,6
1Public Health England Behavioural Insights, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.
Insights
A behaviorally informed letter significantly increased childhood influenza vaccine uptake in GP practices. Reminders via SMS or email showed a minimal increase in school-based vaccination rates.
Area of Science:
- Public Health
- Health Behavior
- Vaccination Programs
Background:
- The UK introduced a national childhood influenza immunization program.
- Behavioral interventions have proven effective for public health uptake.
- This study evaluated behavioral strategies for influenza vaccine uptake in children.
Purpose of the Study:
- To assess the impact of a behaviorally informed letter on influenza vaccine uptake in GP practices.
- To determine the effectiveness of a letter and reminder (SMS/email) on school-based influenza vaccine uptake.
Main Methods:
- Study 1: A cluster-randomized trial involving 21,786 two- and three-year-olds in 250 GP practices, comparing a behavioral letter to usual care.
- Study 2: A factorial trial in 1108 primary schools, testing a behavioral letter and/or a reminder (SMS/email) against standard care.
Main Results:
- In Study 1, the behavioral letter increased vaccination rates from 23.4% to 37.1% (OR=1.93, p<0.001).
- In Study 2, the reminder (SMS/email) increased uptake (β=0.086, p<0.036), but the behavioral letter had no significant effect.
- The overall uptake in Study 2 ranged from 61.6% to 63.5% across conditions.
Conclusions:
- Behaviorally informed invitation letters can enhance childhood influenza vaccine uptake in primary care settings.
- Reminders (SMS/email) can modestly improve school-based influenza vaccine uptake, though the effect size is small.
Background:
The UK is rolling out a national childhood influenza immunisation programme for children, delivered through primary care and schools. Behaviourally-informed letters and reminders have been successful at increasing uptake of other public health interventions. Therefore, we investigated the effects of a behaviourally-informed letter on uptake of the vaccine at GP practices, and of a letter and a reminder (SMS/ email) on uptake at schools.
Methods And Results:
Study 1 was a cluster-randomised parallel trial of 21,786 two- and three-year olds in 250 GP practices, conducted during flu season (September to January inclusive) 2016/7. The intervention was a centrally-sent behaviourally-informed invitation letter, control was usual care. The proportion of two- and three-year olds in each practice who received a vaccination by 31st January 2017 was 23.4% in the control group compared to 37.1% in the intervention group (OR = 1.93; 95% CI = 1.82, 2.05, p < 0.001). Study 2 was a 2 (behavioural letter vs standard letter) × 2 (reminder vs no reminder) factorial trial of 1108 primary schools which included 3010 school years 1-3. Letters were sent to parents from providers, and reminders sent to parents from the schools. In the standard-letter-no-reminder arm, an average of 61.6% of eligible children in each school year were vaccinated, compared to 61.9% in the behavioural-letter-no-reminder arm, 63.5% in the standard-letter-plus-reminder arm, and 62.9% in the behavioural-letter-plus reminder condition, F(3, 2990) = 2.68, p = 0.046. In a multi-level model, with demographic variables as fixed effects, the proportion of eligible students in the school year who were vaccinated increased with the reminder, β = 0.086 (0.041), p < 0.036, but there was no effect of the letter nor any interaction effect.
Conclusion:
Sending a behaviourally informed invitation letter can increase uptake of childhood influenza vaccines at the GP surgery compared to usual practice. A reminder SMS or email can increase uptake of the influenza vaccine in schools, but the effect size was minimal.
Trial Registration:
Study 1: Trial registration: ClinicalTrials.gov Identifier: NCT02921633. Study 2: Trial registration: ClinicalTrials.gov Identifier: NCT02883972.
More Related Videos
Related Concept Videos
01:51Vaccinations
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
01:22Methods of reducing fever
Pharmacological Methods of Reducing Fever:
01:29Immune Response Against Viral Pathogens
NK Cells
NK cells are a crucial part of our innate immune system, acting as the first line of defense against viral infections. These cells can recognize and kill infected cells without prior exposure to the virus, effectively slowing down the spread of infection. Additionally, NK cells produce proinflammatory...