School of Public Health, Curtin University, Perth, Western Australia
Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Subiaco, Western Australia.
Ann Fam Med. 2017 Nov;15(6):507-514. doi: 10.1370/afm.2120.
Seasonal influenza vaccine is recommended and funded for groups at higher risk of serious infection, but uptake is suboptimal. We conducted a randomized controlled trial of short message service (SMS) reminders for influenza vaccination.
Six weeks after seasonal influenza vaccinations began, we identified high-risk patients who had a mobile telephone number on record at 10 practices in Western Australia. Thirty-two percent of the selected patients had already been vaccinated in the current year and were ineligible. Of the remaining 12,354 eligible patients at each practice one-half were randomly assigned to receive a vaccination reminder by SMS (intervention) and the rest received no SMS (control). Approximately 3 months after the SMS was sent (the study period), vaccination data were extracted from the patients' electronic medical records. Log-binomial regression models were used to calculate the relative risk (RR) of vaccination between the intervention and control group.
Twelve-percent (769 of 6,177) of the intervention group and 9% (548 of 6,177) of the control group were vaccinated during the study period, a 39% relative increase attributable to the SMS (RR = 1.39; 95% CI, 1.26-1.54). For every 29 SMSs sent, costing $3.48, 1 additional high-risk patient was immunized. The greatest effect was observed for children younger than 5 years, whose parents were more than twice as likely to have their child vaccinated if they received a SMS reminder (RR = 2.43; 95% CI, 1.79-3.29).
We found SMS reminders to be a modestly effective, low-cost means to increase seasonal influenza vaccine coverage among high-risk patients.
季节性流感疫苗推荐并资助高危感染人群接种，但接种率不理想。我们进行了一项关于短信服务（SMS）提醒接种流感疫苗的随机对照试验。
在季节性流感疫苗接种开始后 6 周，我们在西澳大利亚的 10 个诊所中确定了有移动电话号码记录的高危患者。选择的患者中有 32%已在当年接种，不符合条件。在每个诊所剩余的 12354 名符合条件的患者中，有一半被随机分配接受短信（干预）接种提醒，另一半则不接受短信（对照）。大约在发送短信后 3 个月（研究期间），从患者的电子病历中提取接种数据。使用对数二项式回归模型计算干预组和对照组之间的疫苗接种相对风险（RR）。
干预组中有 12%（769 例），对照组中有 9%（548 例）在研究期间接种了疫苗，短信提示可使接种率相对增加 39%（RR=1.39；95%CI，1.26-1.54）。每发送 29 条短信，成本为 3.48 美元，就可以多为 1 名高危患者接种疫苗。对于 5 岁以下的儿童，效果最为显著，他们的父母如果收到短信提醒，其子女接种疫苗的可能性是未收到提醒的父母的两倍多（RR=2.43；95%CI，1.79-3.29）。
我们发现短信提醒是一种适度有效、低成本的方法，可以提高高危患者的季节性流感疫苗覆盖率。
