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COVID-19 Vaccine Outreach to Elderly Patients: Evaluation of a Text Message Based Approach.

BACKGROUND
The COVID-19 vaccines are vital tools in the defense against infection and serious disease from the 2019 novel coronavirus. There are many challenges to implementing mass vaccination campaigns for large, diverse populations from crafting vaccine promotion messages to reaching individuals in a timely and effective manner. During this unprecedented period, with COVID-19 mass vaccination campaigns essential to protecting vulnerable patient populations and attaining herd immunity, healthcare systems were faced with the dual challenges of vaccine outreach and distribution.


OBJECTIVE
The aim of this cross-sectional study was to assess the effectiveness of a COVID-19 vaccine text outreach approach for patients 65 and older. Our goal was to determine whether this approach was successful in scheduling patients for COVID-19 vaccine appointments.


METHODS
We developed text messages using the SMS platform Tavoca. These messages informed patients of their vaccine eligibility and allowed them to indicate their interest in scheduling an appointment via a specific method (email or phone) or indicate their lack of interest in the vaccine. We tracked the status of these messages and how patients responded. Messages were sent to patients 65 and older (N=30,826) at a non-profit healthcare system in Washington, D.C. Data were collected and examined from January 14, 2021 to May 10, 2021. Data were analyzed using multivariate multinomial and binary logistic regression models in SAS 9.4.


RESULTS
Approximately 57% of text messages were delivered to patients, but many messages received no response from patients (40%). Additionally, 42.1% (12,978/30,826) of messages were not delivered. Of the patients who expressed interest in the vaccine (2,938/30,826, 9.5%), Black/African American patients preferred a phone call versus email for scheduling their appointment (OR 1.69, 95%CI: 1.29-2.21) compared to White patients. Patients ages 70-74 were more likely to schedule an appointment (OR 1.38, 95%CI: 1.01-1.89) than patients ages 65-69, and Black/African American patients were more likely to schedule an appointment (OR 2.90, 95%CI: 1.72-4.91) than White patients.


CONCLUSIONS
This study provided insights into some advantages and challenges of using text messaging vaccine outreach for patients 65 and older. Lessons learned from this vaccine campaign underscore the importance of using multiple outreach methods and sharing of patient vaccination status between health systems, along with a patient-centered approach to address vaccine hesitancy and access issues.


CLINICALTRIAL