BACKGROUND AND OBJECTIVES Among children requiring 2 influenza doses in a given season, second dose receipt nearly halves the odds of influenza. Nationally, many children do not receive both needed doses. This study sought to compare the effectiveness of text message reminders with embedded interactive educational information versus usual care on receipt and timeliness of the second dose of influenza vaccine. METHODS This trial took place over the 2017 to 2018 and 2018 to 2019 influenza seasons among 50 pediatric primary care offices across 24 states primarily from the American Academy of Pediatrics' Pediatric Research in Office Settings practice-based research network. Caregiver-child dyads of children 6 months to 8 years in need of a second influenza vaccination that season were individually randomized 1:1 into intervention versus usual care, stratified by age and language within each practice. Intervention caregivers received automated, personalized text messages, including educational information. Second dose receipt by April 30 (season end) and by day 42 (2 weeks after second dose due date) were assessed using Mantel Haenszel methods by practice and language. Analyses were intention to treat. RESULTS Among 2086 dyads enrolled, most children were 6 to 23 months and half publicly insured. Intervention children were more likely to receive a second dose by season end (83.8% versus 80.9%; adjusted risk difference (ARD) 3.8%; 95% confidence interval [0.1 to 7.5]) and day 42 (62.4% versus 55.7%; ARD 8.3% [3.6 to 13.0]). CONCLUSIONS In this large-scale trial of primary care pediatric practices across the United States, text message reminders were effective in promoting increased and timelier second dose influenza vaccine receipt.

中文翻译：

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儿童第二剂流感疫苗的短信提醒：随机对照试验。

背景和目标 在一个特定季节需要接种两剂流感疫苗的儿童中，接受第二剂流感的几率几乎减半。在全国范围内，许多儿童没有接受两种所需的剂量。这项研究旨在比较带有嵌入式互动教育信息的短信提醒与第二剂流感疫苗接收和及时性的常规护理的有效性。方法 这项试验在 2017 年至 2018 年和 2018 年至 2019 年流感季节在 24 个州的 50 个儿科初级保健办公室进行，主要来自美国儿科学会的儿科研究办公室设置实践研究网络。当季需要第二次流感疫苗接种的 6 个月至 8 岁儿童的看护者-儿童二人组被单独随机分为干预组和常规护理组，并按每次实践中的年龄和语言进行分层。干预护理人员收到自动的个性化短信，包括教育信息。使用 Mantel Haenszel 方法通过实践和语言评估 4 月 30 日（赛季结束）和第 42 天（第二剂到期日后 2 周）的第二剂接收情况。分析是意向治疗。结果 在登记的 2086 名儿童中，大多数儿童年龄为 6 至 23 个月，并且一半有公共保险。干预儿童更有可能在赛季结束时（83.8% 对比 80.9%；调整后风险差 (ARD) 3.8%；95% 置信区间 [0.1 至 7.5]）和第 42 天（62.4% 对比 55.7%；ARD）接受第二剂疫苗8.3% [3.6 至 13.0]）。结论 在这项针对美国初级保健儿科实践的大规模试验中，短信提醒可以有效促进增加和更及时地接种第二剂流感疫苗。