Text message reminders to promote human papillomavirus vaccination

Abstract

Objective: To implement and evaluate text message reminders for the second (HPV2) and third (HPV3) vaccine doses.

Design: Site-based intervention.

Setting: Nine pediatric sites (5 academic and 4 private) located in New York City.

Participants: Parents of adolescents 9-20 years who received HPV1 or HPV2 during the intervention period, January-June 2009.

Intervention: Parents who enrolled received up to three weekly text message reminders that their daughter was due for her next vaccine dose.

Outcome measure: On-time receipt of the next vaccine dose, within one month of its due date.

Results: During the intervention period, of 765 eligible HPV vaccine events, 434 enrollment instructions were distributed to parents (56.7% of doses). Parents of 124 adolescent girls (28.6% of those handed instructions) activated text message reminders. Comparing children of parents who enrolled versus those who did not, on-time receipt of next HPV vaccine dose occurred among 51.6% (95% CI 42.8-60.4%) versus 35.0% (95% CI 29.6-40.2%) of adolescents (p=.001). Similarly, among a historical cohort of adolescents, receiving HPV1 or HPV2 in the six months prior to the intervention period, on-time receipt of next vaccine dose was noted for 38.1% (95% CI 35.2-41.0%) (p=.003). Increases in receipt of next vaccine dose among intervention subjects were sustained at 4 months following the vaccine due date. Using a logistic regression model, after controlling for insurance and site of care, intervention subjects were significantly more likely than either control population to receive their next HPV vaccine dose on-time.

Conclusion: Among those choosing to enroll, text message reminders were an effective intervention to increase on-time receipt of HPV2 or HPV3.