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Nudging towards COVID-19 and influenza vaccination in children with medically at-risk conditions
Bing Wang1,2,3, Prabha Andraweera1,2,3, Margie Danchin4,5,6
1Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, SA Health, 72 King William Rd, North Adelaide, South Australia 5006, Australia.
Insights
Nudge interventions did not increase COVID-19 or influenza vaccine uptake in medically at-risk children. Low vaccination rates and evolving public trust may have impacted these health behavior promotion results.
Area of Science:
- Public Health
- Behavioral Science
- Vaccinology
Background:
- Non-coercive 'nudge' interventions show promise for promoting health behaviors.
- This study assessed nudge interventions' impact on COVID-19/influenza vaccine uptake in children with medical risk factors.
Purpose of the Study:
- To evaluate the effectiveness of multicomponent nudge interventions in increasing COVID-19 and influenza vaccine uptake among pediatric patients with medically at-risk conditions.
Main Methods:
- Two randomized controlled trials (RCTs) were conducted, comparing standard care with multicomponent nudge interventions (text messages with video links based on the MINDSPACE framework).
- Participants were randomized 1:1 to either the intervention or standard care group.
- A significant portion (15.3%) opted out of text messages in the COVID-19 RCT.
Main Results:
- No significant difference in COVID-19 vaccine uptake was observed between the intervention (1.4%) and standard care (1.6%) groups (OR: 0.89; 95% CI: 0.34-2.35).
- Similarly, no difference in influenza vaccine uptake was found between the intervention (25.7%) and standard care (23.8%) groups (OR: 1.11; 95% CI: 0.85-1.45).
Conclusions:
- The tested nudge interventions were ineffective in boosting COVID-19/influenza vaccine uptake in this pediatric population.
- Low baseline vaccination rates and potential shifts in public trust towards technology and communication may have influenced the study's outcomes.
- Future nudge strategies may require adaptation to evolving societal factors and trust dynamics.
Background:
Non-coercive 'nudge' interventions have shown the potential to promote health behaviours. This study aimed to evaluate the impact of nudge interventions on COVID-19/influenza vaccine uptake among children with medically at-risk conditions.
Methods:
Randomized controlled trials (RCTs) were conducted, and participants were randomized (1:1) to standard care or intervention. The multicomponent nudge interventions included three text messages with video links, developed using the MINDSPACE framework.
Results:
In the COVID-19 RCT, 554 were randomized to intervention and 552 to standard care, with 15.3% opting out of text messages. Over 3 months, eight children in the intervention group (1.4%) and nine in the standard care group (1.6%) received at least one dose of COVID-19 vaccine (odds ratio (OR): 0.89; 95% confidence interval (CI): 0.34-2.35). In the influenza RCT, 564 were randomized to intervention and 567 to standard care. There was no difference in the percentage vaccinated against influenza between the intervention (25.7%) and standard care (23.8%) groups (OR: 1.11; 95% CI: 0.85-1.45).
Conclusions:
The nudge interventions were ineffective at increasing COVID-19/influenza vaccine uptake. The study included mostly unvaccinated children, and low vaccination rates during the study likely impacted the evaluation results. Nudges may need to evolve with changes to public trust in technology and communications.
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