Research highlights:
- Three clinical trials in Denmark increased vaccination rates among more than 2 million adults by ‘urging’ patients to get the flu shot with electronic messages emphasizing its cardiovascular benefits. Improved.
- The study observed significant improvements with vaccination and showed that this nudge was particularly effective for people with a history of heart attacks.
- The researchers said this low-cost, scalable strategy to encourage annual influenza vaccination should be considered globally to improve vaccination coverage across health systems and countries.
- Note: The research presented in this news release is a research summary. Abstracts presented at American Heart Association scientific meetings are not peer-reviewed, and research results are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.
Embargoed until Sunday, November 17, 2024, 3:45 PM CT / 4:45 PM ET
This news release contains updated information from researchers not listed in the abstract.
CHICAGO, Nov. 17, 2024 — An e-letter, or nudge, highlighting the cardiovascular benefits of the influenza vaccine increases vaccination rates among more than 2 million adults and those who have had a heart attack. had a great influence on This is the second consecutive flu season in Denmark. This was a cutting-edge scientific discovery presented today at the American Heart Association’s 2024 Scientific Sessions. The conference, to be held in Chicago from November 16 to 18, 2024, is the premier global exchange based on the latest scientific advances, research and evidence. Updates on clinical practice in cardiovascular science. This study will be published simultaneously today Journal of the American Medical Association – Cardiology (JAMA Cardiology).
American Heart Association and Centers for Disease Control and Prevention (CDC) recommend Annual influenza vaccination for almost everyone over 6 months of age, including people with heart disease, with rare exceptions. Influenza vaccination (also known as influenza vaccine) is very important to prevent influenza and its related complications. In addition to preventing infection, regular influenza vaccination has also been shown to reduce serious cardiovascular health problems in people who have had a heart attack.
“The annual influenza vaccine helps prevent influenza infection and has a potential heart-protective effect in patients who have had a heart attack,” said the study’s lead author, from Kaiser Permanente San Francisco Medical Center. said cardiologist Ankeet Bhatt, MD, MBA, MSc. He is a research fellow in Kaiser Permanente’s Northern California Research Division and an adjunct professor at Stanford University School of Medicine in Palo Alto, California. “However, there are significant gaps in the implementation of this effective treatment, and new and scalable strategies to improve influenza vaccination coverage are needed.”
In Denmark, about 80% of older people have received a flu shot, but only about 40% of younger people with chronic conditions have received a flu shot, Butt added.
In the United States, approximately 45% of adults and 55% of children received at least one dose of influenza vaccine during the 2023-2024 influenza season. According to the CDC.
To identify which outreach methods can help increase influenza vaccination uptake, study authors found that during two recent influenza seasons in Denmark, e-letter-based reminders were effective in increasing the number of elderly and chronically ill people. We assessed whether it would improve vaccine use in a broader population, including people with disabilities. .
Researchers conducted three national clinical trials. Nudge Influenza-2; Nudge Influenza will become chronic in the 2022-2023 and 2023-2024 influenza seasons. Each trial assessed a series of behavioral science-based nudges delivered through the government’s email/letter system. Participants were randomly selected to receive either an email encouraging influenza vaccination or no email reminder/standard of care. E-letters explaining the potential cardiovascular benefits of influenza vaccination were more effective in increasing vaccination rates.
The research found the following:
- Compared to usual care, vaccination rates were higher among those who received the nudge email, with a 1.8% improvement among heart attack survivors and a 1.3% increase among adults without a history of heart attack.
- Messages explaining the potential cardiovascular benefits of influenza vaccination were more effective, with a 2% increase in vaccinations among people with a history of heart attack compared to people without a history of heart attack. led to a 3.9% increase in vaccinations.
- Among heart attack survivors, emails focusing on cardiovascular benefits were even more successful among people who had not been vaccinated during the previous flu season. People in this subcategory had a nearly 14% improvement rate with influenza vaccination, while heart attack survivors who had previously been vaccinated had an improvement rate of only about 1.5%.
- In one of the trials (NUDGE-FLU-CHRONIC), nudges emphasizing cardiovascular benefits were even more effective among young adults who had recently had a heart attack, with a 26% increase vs. a 14% increase, respectively. . “These particularly important groups, those who have not been previously vaccinated or those who have recently had a heart attack, may be the ones that would benefit the most cardiovascular protection from vaccination,” Bhatt said. said.
“Data suggest that cardiovascular-focused messaging is effective across a wide range of populations. It should be considered as part of a suite of strategies to encourage influenza vaccination among at-risk patients,” said Bhatt. “Of note, this strategy alone was not able to close all influenza vaccination implementation gaps. Messaging-based interventions are needed to fully close this important prevention gap in at-risk patients. In addition, other strategies should be tested.”
Given the encouraging results across this large population during the last two influenza seasons, this low-cost and highly scalable strategy may be useful, especially if validated in other global healthcare settings. , population-level support should be considered worldwide to improve influenza vaccination coverage across health systems. Nations, he said.
A limitation of this study is that it was based on a prespecified secondary analysis across trials. This means that the research is not dedicated to answering this question only. Additionally, influenza vaccination rates were particularly high among older people in Denmark. Vaccination rates may be much lower in other parts of the world. Further research is needed to determine whether that changes the strategy’s effectiveness in populations with low vaccination rates, and testing efforts have already begun in the United States, Butt said.
Research details, background and design:
- More than 2 million adults aged 18 to 64 participated in clinical trials.
- More than 59,450 participants had a history of heart attack, compared to 11,760 in the NUDGE-FLU CHRONIC trial and more than 47,690 in the NUDGE-FLU and NUDGE-FLU 2 trials combined.
- Among patients with a history of heart attack, the average age across the three trials was 70 years, and 28% were women.
Co-authors, disclosures, and funding sources are listed in the abstract.
Research statements and conclusions presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the policy or position of the association. The Association makes no representations or warranties regarding its accuracy or reliability. Abstracts presented at the Society’s scientific conferences are not peer-reviewed, but are selected by an independent review committee and considered based on their potential to increase the diversity of scientific issues and views discussed at the conference. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.
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