A megastudy of text-based nudges encouraging patients to get vaccinated at an upcoming doctor’s appointment

Milkman, Katherine L.; Patel, Mitesh S.; Gandhi, Linnea; Graci, Heather N.; Gromet, Dena M.; Ho, Hung; Kay, Joseph S.; Lee, Timothy W.; Akinola, Modupe; Beshears, John; Bogard, Jonathan E.; Buttenheim, Alison; Chabris, Christopher F.; Chapman, Gretchen B.; Choi, James J.; Dai, Hengchen; Fox, Craig R.; Goren, Amir; Hilchey, Matthew D.; Hmurovic, Jillian; John, Leslie K.; Karlan, Dean; Kim, Melanie; Laibson, David; Lamberton, Cait; Madrian, Brigitte C.; Meyer, Michelle N.; Modanu, Maria; Nam, Jimin; Rogers, Todd; Rondina, Renante; Saccardo, Silvia; Shermohammed, Maheen; Soman, Dilip; Sparks, Jehan; Warren, Caleb; Weber, Megan; Berman, Ron; Evans, Chalanda N.; Snider, Christopher K.; Tsukayama, Eli; Van den Bulte, Christophe; Volpp, Kevin G.; Duckworth, Angela L.

Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor’s appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.