Nudging towards COVID-19 and influenza vaccination in children with medically at-risk conditions

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dc.contributor.authorWang, B.
dc.contributor.authorAndraweera, P.
dc.contributor.authorDanchin, M.
dc.contributor.authorBlyth, C.C.
dc.contributor.authorVlaev, I.
dc.contributor.authorOng, J.J.
dc.contributor.authorDodd, J.
dc.contributor.authorCouper, J.
dc.contributor.authorSullivan, T.R.
dc.contributor.authorCuthbert, A.R.
dc.contributor.authorRak, A.
dc.contributor.authorHerewane, K.
dc.contributor.authorPaparo, L.
dc.contributor.authorKarnon, J.
dc.contributor.authorSpurrier, N.
dc.contributor.authorCusack, M.
dc.contributor.authorMordaunt, D.
dc.contributor.authorSimatos, D.
dc.contributor.authorDekker, G.
dc.contributor.authorCarlson, S.
dc.contributor.authoret al.
dc.date.issued2025
dc.descriptionOnlinePubl. Available online 6 August 2025
dc.description.abstractBackground: Non-coercive ‘nudge’ interventions have shown the potential to promote health behaviours. This study aimed to evaluate the impact of nudge interventions on COVID-19/influenza vaccine uptake among children with medically at-risk conditions. Methods: Randomized controlled trials (RCTs) were conducted, and participants were randomized (1:1) to standard care or intervention. The multicomponent nudge interventions included three text messages with video links, developed using the MINDSPACE framework. Results In the COVID-19 RCT, 554 were randomized to intervention and 552 to standard care, with 15.3% opting out of text messages. Over 3 months, eight children in the intervention group (1.4%) and nine in the standard care group (1.6%) received at least one dose of COVID-19 vaccine (odds ratio (OR): 0.89; 95% confidence interval (CI): 0.34–2.35). In the influenza RCT, 564 were randomized to intervention and 567 to standard care. There was no difference in the percentage vaccinated against influenza between the intervention (25.7%) and standard care (23.8%) groups (OR: 1.11; 95% CI: 0.85–1.45). Conclusions: The nudge interventions were ineffective at increasing COVID-19/influenza vaccine uptake. The study included mostly unvaccinated children, and low vaccination rates during the study likely impacted the evaluation results. Nudges may need to evolve with changes to public trust in technology and communications.
dc.description.statementofresponsibilityBing Wang, Prabha Andraweera, Margie Danchin, Christopher C. Blyth, Ivo Vlaev, Jason J. Ong, Jodie Dodd, Jennifer Couper, Thomas R. Sullivan, Alana R. Cuthbert, Ashleigh Rak, Kirsty Herewane, Louisa Paparo, Jonathan Karnon, Nicola Spurrier, Michael Cusack, Dylan Mordaunt, Dimi Simatos, Gus Dekker, Samantha Carlson, Jane Tuckerman, Nicholas Wood, Lisa Whop, and Helen S. Marshall
dc.identifier.citationJournal of Public Health, 2025; fdaf097-1-fdaf097-12
dc.identifier.doi10.1093/pubmed/fdaf097
dc.identifier.issn1741-3842
dc.identifier.issn1741-3850
dc.identifier.orcidAndraweera, P. [0000-0003-2434-8370]
dc.identifier.orcidCouper, J. [0000-0003-4448-8629]
dc.identifier.orcidKarnon, J. [0000-0003-3220-2099]
dc.identifier.urihttps://hdl.handle.net/2440/147796
dc.language.isoen
dc.publisherOxford University Press
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/2014684
dc.rights© The Author(s) 2025. Published by Oxford University Press on behalf of the Faculty of Public Health. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
dc.source.urihttps://doi.org/10.1093/pubmed/fdaf097
dc.subjectchildren; COVID-19; infectious disease
dc.titleNudging towards COVID-19 and influenza vaccination in children with medically at-risk conditions
dc.typeJournal article
pubs.publication-statusPublished online

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