Flu Outreach: Increasing Adult Vaccinations via Text Message
The Challenge: Increase Adult Flu Vaccination Rate Without Increasing Healthcare Staff’s Workload
Before the 2021–22 flu season got started, health officials were anxious. Although the previous year’s case numbers had been remarkably low—largely thanks to strict mask and social-distancing protocols—experts worried that flu might come roaring back. Much of the public had tired of the constant mask-wearing, putting them at higher risk for catching the flu and other respiratory diseases. 
Statistics from a recent study  confirmed the anxiety wasn’t misplaced: From January 2020 to July 2021, monthly vaccine claims decreased on average 32% for adults and 36% for adolescents when compared to the same months in 2019.
And while practices worked hard to get people back into the office for well visits and other critical care, they were running with fewer staff on-hand, many of whom were exhausted from the past two years of pandemic chaos. There was little bandwidth for the yearly influx of flu vaccinations—let alone a concerted patient outreach effort.
The Plan: Reach Out to Patients Directly Via Text
To overcome the obstacles of low rates and depleted staff, we built a system that sent timely text prompts to unvaccinated patients, encouraging them to get their flu shot at their upcoming primary care appointment. By focusing our efforts on patients with an upcoming appointment (an opportunity for action) and an existing need (not yet protected against flu) we felt we were giving our partner practices the best odds of getting more shots in arms.
To avoid adding additional burden to practice staff, we automated the text messages and sent them through our system. But it was important to us—and to our practice partners—that the texts felt like they were coming straight from their doctor’s office. “We’d never done anything like this before,” said Dr. Jonathan Cook, founder of Clarke-Oconee Family Practice in Athens, Georgia. “We thought it would be a great way to reach out ‘directly’ to encourage our patients to come back to the office—and to keep them protected from what might be an active flu season.”
The Program: Flu Outreach
The initial run of our pilot program Flu Outreach included adult patients (19+) and focused on two states, Georgia and Kentucky. Text messages hit patients’ phones on September 7, 2021 and the program continued until December, 2021.
Here’s what happened:
- We sent our practice partners exclusive stickers and posters to encourage patients to get their flu shots.
- We ensured each healthcare provider had a plentiful supply of flu vaccine on-hand so they were prepared for the influx of patients.
- Patients with a scheduled appointment received text messages 72 hours before their appointment and then again 24 hours before, reminding them to get their flu shot while they were at the office.
- Throughout the program period, we sent our practice partners weekly reports on their performance.
We actually had several patients who came in for their appointment and reminded us that they were supposed to get the flu shot, all because they’d received the text.
Soon after the program began, we started hearing from our partners about how much the program was helping. “We actually had several patients who came in for their appointment and reminded us that they were supposed to get the flu shot, all because they’d received the text,” says Cathy Lee, practice manager at Crossroads Family Medicine in Campbellsville, Kentucky. “That had never happened before!”
With practice staff working overtime to care for their patients day in and day out, many felt that our Flu Outreach program relieved a burden. “The outreach was great,” said Quartisha Carruth, practice manager at Clarke-Oconee. “But the other big stress-reliever was knowing that more flu vaccines were being sent to us automatically without us having to remember to order them and keep the vaccine fridge filled.”
When all was said and done, the 29 offices that participated in Flu Outreach were 77% more likely to vaccinate patients with appointments while the program was active compared to our practice partners that were not enrolled in the program.
VaxCare is proud to work alongside our practice partners to help protect their patients. Together, we’re working to close immunization gaps, meet Account Care Organization (ACO) standards, and improve Healthcare Effectiveness Data Information Set (HEDIS) scores.
Our Flu Outreach program proved that it’s possible to increase flu vaccination rates without adding additional work for a practice’s staff. We’re excited to build on what we’ve learned from this pilot to create a program for the 2022–23 flu season—one that allows us to help even more clinics deliver on the “triple aim” of better care, lower costs, and improved patient outcomes.
 Kyuen Lee et al. “Estimating the Impact of Low Influenza Activity in 2020 on Population Immunity and Future Influenza Seasons in the United States,” Open Forum Infectious Diseases, Volume 9, Issue 1, January 23, 2022, https://academic.oup.com/ofid/article/9/1/ofab607/6481736.
 Christine Liow et al. “Declines in Routine Adult and Teen Vaccinations Continued in 2021,” January 10, 2022, https://avalere.com/insights/declines-in-routine-adult-and-teen-vaccinations-continued-in-2021.
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