Text message reminders that were tailored or included a reminder doubled the chance that expectant and new mothers would receive an influenza vaccine in a new randomized trial of Text4baby, a texting service for new mothers, published in the American Journal of Preventive Medicine. As a result of these findings, vaccination reminders will be incorporated into Text4baby going forward during flu season.

“In this randomized evaluation, Text4baby mothers who received a reminder were twice as likely to report they were vaccinated and the odds of vaccination were increased among all participants who reported their status,” lead author Elizabeth Jordan, an associate professor at the University of South Florida, College of Nursing, said in a statement. “Also, Text4baby mothers who initially reported they were not planning to be vaccinated due to cost were nearly twice as likely to report vaccination at follow-up after receiving a single text on how to access free and low-cost influenza vaccines.”

Text4baby is a texting program created by Voxiva for new and expected mothers. It has reached more than 900,000 new mothers since its 2010 launch. Women who enroll in the service receive three free text messages each week. The texts are sent from early in the pregnancy and up through the baby’s first birthday. Topics addressed in texts include labor signs and symptoms, prenatal care, urgent alerts, developmental milestones, immunizations, nutrition, birth defect prevention, safe sleep, and safety. 

The University of South Florida College of Nursing and the Johns Hopkins Bloomberg School of Public Health partnered with Text4baby on the study, which looked at 89,000 Text4baby enrollees. All the enrollees were sent a text message asking them about their vaccination plans and about one third responded.

Those that responded they were planning to get vaccinated were randomized into two groups: one received an encouragement message and the other group got the encouragement message plus the opportunity to schedule a reminder. Those that said they weren't planning to get vaccinated were also randomized into two groups: one received general education on vaccinations, the other received information tailored to the reason they gave for not getting vaccinated.

The study found that the reminders doubled women's chances of actually getting the vaccine. The tailored text messages, on the other hand, only had an effect on women who identified high cost as the reason they weren't getting vaccinated. Their tailored message gave information about low-cost vaccination options.

“Influenza vaccination was identified as a critical issue to target at the inception of Text4baby," Voxiva Chief Health Officer Dr. Pamela Johnson said in a statement. "Based on these results we are confident that the majority of participants enrolled in Text4baby will receive timely influenza vaccination this upcoming season.”