A cluster randomized controlled trial of a modified vaccination clinical reminder for primary care providers

Objective: Adult vaccination rates in the United States fall short of national goals, and rates are particularly low for Black Americans. We tested a provider-focused vaccination uptake intervention: a modified electronic health record clinical reminder that bundled together three adult vaccination reminders, presented patient vaccination history, and included talking points for providers to address vaccine hesitancy. Method: Primary care teams at the Atlanta Veterans Affairs Medical Center, who saw 28,941 patients during this period, were randomly assigned to receive either the modified clinical reminder (N = 44 teams) or the status quo (N = 40 teams). Results: Uptake of influenza and other adult vaccinations was 1.6 percentage points higher in the intervention group, which was not statistically significant (CI = [-1.3, 4.4], p = 0.28). The intervention had similar effects on Black and White patients and did not reduce the disparity in vaccination rates between these groups. Conclusion: Provider-focused interventions are a promising way to address vaccine hesitancy, but they may need to be more intensive than a modified clinical reminder to have appreciable effects on vaccination uptake

Lessons for COVID-19 vaccination from eight federal government direct communication evaluations

We discuss eight randomized evaluations intended to increase vaccination uptake conducted by the US General Services Administration’s Office of Evaluation Sciences (OES). These evaluations had a median sample size of 55,000, deployed a variety of behaviorally-informed direct communications, and used administrative data to measure vaccination uptake. The confidence interval from an internal meta-analysis shows changes in vaccination rates ranging from -0.004 to 0.394 percentage points. Two studies yielded statistically significant increases, of 0.59 and 0.16 percentage points. The other six were not statistically significant, although the studies were powered to detect effect sizes in line with published research. This work highlights the likely effects of government communications and demonstrates the value of conducting rapid evaluations to support COVID-19 vaccination efforts

sj-pdf-1-bsx-10.1177_23794607231192690 – Supplemental material for Using communication to boost vaccination: Lessons for COVID-19 from evaluations of eight large-scale programs to promote routine vaccinations

Supplemental material, sj-pdf-1-bsx-10.1177_23794607231192690 for Using communication to boost vaccination: Lessons for COVID-19 from evaluations of eight large-scale programs to promote routine vaccinations by Heather Barry Kappes, Mattie Toma, Rekha Balu, Russ Burnett, Nuole Chen, Rebecca Johnson, Jessica Leight, Saad B. Omer, Elana Safran, Mary Steffel, Kris-Stella Trump, David Yokum and Pompa Debroy in Behavioral Science & Policy</p