News Release

Text message reminders may get more parents to vaccinate kids against flu

Peer-Reviewed Publication

Columbia University's Mailman School of Public Health

Text message reminders to parents about flu vaccinations may help boost the number of children vaccinated, according to researchers at Columbia University Medical Center and NewYork-Presbyterian Hospital. Full study findings are reported in the April 25 issue of the Journal of the American Medical Association (JAMA).

"Text messaging can be a very effective tool for reaching large numbers of people in need of vaccination, whether they are children or adults," says lead author Melissa Stockwell, MD, MPH, assistant professor of Pediatrics and Population and Family Health at the Columbia University College of Physicans and Surgeons and Columbia's Mailman School of Public Health. "Even small increases in the flu vaccination rates can lead to large numbers of protected individuals."

The researchers focused on hard-to-reach, low-income, urban children and adolescents. "This group is at increased risk for influenza due to crowded living situations. The traditional method of using phone or mailed reminders has done little to improve low vaccination rates," says Dr. Stockwell, who is also a pediatrician at NewYork-Presbyterian Hospital.

The randomized, controlled study followed 9,213 children and adolescents ages 6 months to 18 years who were receiving care at four community-based clinics in Upper Manhattan during the 2010-2011 flu season. A total of 7,574 had not received a flu vaccine prior to the intervention start date and were included in the analysis. The children and adolescents in the study were primarily minority, 88% were publicly insured, and 58% were from Spanish-speaking families.

Parents of children assigned to the text-message intervention received up to five weekly texts providing educational information and instructions on where the vaccinations were administered. Everyone in the study received the usual care, an automated telephone reminder, and access to informational flyers posted at the study sites.

As of March 31, 2011, a higher proportion of children and adolescents in the intervention group (43.6%) compared with the usual care group (39.9%) received the influenza vaccine. As of the Fall 2010, 27.1% of the text-message group vs. 22.8% of the usual care group had received the vaccine.

Vaccination coverage overall remained low, as it does nationally. The researchers recommend further studies to identify ways to maximize the potential of text messaging.


The study was supported by a grant from the Maternal and Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services.


About Columbia University's Mailman School of Public Health

Founded in 1922 as one of the first three public health academies in the nation, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,000 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including the International Center for AIDS Care and Treatment Programs (ICAP), the National Center for Disaster Preparedness, and the Center for Infection and Immunity. For more information, please visit

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