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Narrative Reminder Recall to Improve Pediatric Influenza Vaccination: A Pilot Randomized Clinical Trial
Joshua T B Williams1,2,3, Kate Kurlandsky1, Amy B Stein3
1Denver Health, Denver, Colorado.
JAMA Network Open
|January 6, 2026
Summary
Digital stories improved pediatric influenza vaccination rates in a pilot study, despite low initial engagement. This intervention shows promise for increasing vaccine uptake in vulnerable communities.
Area of Science:
- Public Health
- Health Equity
- Digital Health Interventions
Background:
- Seasonal influenza poses significant risks, particularly in vulnerable populations.
- Digital storytelling offers a scalable, equity-promoting approach to increase vaccination rates.
Purpose of the Study:
- To evaluate the reach of pediatric influenza vaccine digital stories among caregivers.
- To determine the association between caregiver intervention and child influenza vaccination timing.
Main Methods:
- Pilot randomized clinical trial in safety-net clinics serving historically Black neighborhoods.
- Intervention: Text messages with links to digital stories; Control: Usual care via electronic health record.
- Primary outcome: Digital story reach; Secondary outcome: Time to child influenza vaccination.
Main Results:
- 100% of texts were delivered, but only 7% of caregivers viewed the digital stories.
- Children of intervention group caregivers showed higher vaccination rates (38% unvaccinated) compared to usual care (26% unvaccinated).
- Adjusted analyses indicated a 63% increased likelihood of vaccination for children in the intervention group.
Conclusions:
- Text message-based digital storytelling intervention improved pediatric influenza vaccination rates.
- Low intervention reach was observed, suggesting a need for optimization.
- The intervention shows potential for promoting health equity in vaccination among Black families.
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