Studies show that well designed text messages help get people vaccinated

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Sun, 2021-06-06 16:52 — mike kraft

Perspective | These are the text messages that get people to take vaccines Telling people that a vaccination is ready and waiting for them makes more people get their shot. Katy Milkman, Angela Duckworth, Mitesh Patel Washington Post

More than 169 million Americans have received one or both doses of a coronavirus vaccine, but demand is falling off rapidly. Doses administered peaked at an average of 3.3 million per day in mid-April but are now down to under 1.5 million per day. To meet the goal of getting at least one shot to 70 percent of American adults by July 4, the Biden administration announced Wednesday that it would partner with child-care centers to free up people to get injections, and provide vaccine information (and even doses) through Black-owned barbershops and beauty salons. Anheuser-Busch will give a beer to Americans over 21 if the country meets Biden’s goal, and some states, notably West Virginia, Maryland and Ohio, are using cash incentives.

Our research demonstrates that a less-flashy effort might also have a significant effect in boosting vaccination rates: text messages. In a new study involving more than 47,000 people, we identified messages that were able to “nudge” people who were scheduled for a primary-care doctor’s visit to get a flu shot during that visit. Although the study took place last fall, before coronavirus vaccines were widely available, we designed the messages so they could be repurposed for the new vaccines.

After soliciting suggestions for different approaches from dozens of experts, our large, interdisciplinary team tested 19 text messages that ranged from jokey and casual to sober and professional. One of the latter turned out to be the most effective: 72 hours before a doctor’s visit, we told patients that it was flu season and that “a flu vaccine is available for you.” Then, 24 hours before the appointment, we informed them that “a flu vaccine has been reserved for your appointment.” The proportion of people in the control group who got a flu shot was 42 percent.

The “reserved for you” nudge raised that figure by 4.6 percentage points, as we reported in the Proceedings of the National Academy of Sciences last month. (All patients in the study — including the control group — were supposed to be offered a vaccine by their doctor, but we can’t be sure that happened in every case.)

Likewise, in a similar study we conducted involving roughly 700,000 Walmart pharmacy customers, texts reminding patients that a flu vaccine was “waiting for you” lifted vaccination rates more than any other line of messaging did.

A hundred bucks or a chance at $1 million: What’s the better vaccine incentive?

Why do text message reminders using phrases such as “reserved for you” and “waiting for you” work so well? It might be because this language makes patients feel as if the vaccine belongs to them, and they may not want to miss out on “their” dose.

Research also shows that people are more likely to accept default options than to choose to opt in to the same course of action. One reason is that defaults are presumed to be the recommended path. Accepting defaults is also perceived to take less effort. After all, you’re just going along with what has already been arranged and accepting a vaccine that’s ready and waiting. (That impression apparently matters, even if it takes little to no effort to simply say yes when a doctor offers you a vaccine after you receive a different text, or no text at all.) ...

Compared with other tactics, including glitzy ad campaigns and cash incentives, strategies based on text messaging are virtually costless. Yet they move the needle (literally). And unlike mandates, nudges preserve the autonomy of individuals to make their own decisions. We aren’t advocating against cash rewards or mandates — far from it. In our view, in the race to end the pandemic, the more approaches, the better.

But let’s not overlook an easy and cost-effective tactic based on solid behavioral science. ...

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