Abstract
Background
Influenza and COVID-19 infections during pregnancy may have serious adverse consequences for women as well as their infants. However, uptake of influenza and COVID-19 vaccines during pregnancy remains suboptimal. This study aims to assess the effectiveness of a multi-component nudge intervention to improve influenza and COVID-19 vaccine uptake among pregnant women.
Methods
Pregnant women who receive antenatal care at five tertiary hospitals in South Australia, Western Australia and Victoria will be recruited to two separate randomised controlled trials (RCTs). Women will be eligible for the COVID-19 RCT is they have received two or less doses of a COVID-19 vaccine. Women will be eligible for the influenza RCT if they have not received the 2023 seasonal influenza vaccine. Vaccination status at all stages of the trial will be confirmed by the Australian Immunisation Register (AIR). Participants will be randomised (1:1) to standard care or intervention group (n = 1038 for each RCT). The nudge intervention in each RCT will comprise three SMS text message reminders with links to short educational videos from obstetricians, pregnant women and midwives and vaccine safety information. The primary outcome is at least one dose of a COVID-19 or influenza vaccine during pregnancy, as applicable. Logistic regression will compare the proportion vaccinated between groups. The effect of treatment will be described using odds ratio with a 95% CI.
Discussion
Behavioural nudges that facilitate individual choices within a complex context have been successfully used in other disciplines to stir preferred behaviour towards better health choices. If our text-based nudges prove to be successful in improving influenza and COVID-19 vaccine uptake among pregnant women, they can easily be implemented at a national level.
Trial registration
ClinicalTrials.gov Identifier NCT05613751. Registered on November 14, 2022.
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Details
1 Women’s and Children’s Hospital, SA Health, Vaccinology and Immunology Research Trials Unit, Adelaide, Australia (GRID:grid.1694.a); Robinson Research Institute, The University of Adelaide, Adelaide, Australia (GRID:grid.1010.0) (ISNI:0000 0004 1936 7304); The University of Adelaide, Adelaide Medical School, Adelaide, Australia (GRID:grid.1010.0) (ISNI:0000 0004 1936 7304)
2 The Royal Children’s Hospital, Melbourne, Australia (GRID:grid.416107.5) (ISNI:0000 0004 0614 0346); The University of Melbourne, Department of Paediatrics, Melbourne, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X)
3 Perth Children’s Hospital, Perth, Australia (GRID:grid.518128.7) (ISNI:0000 0004 0625 8600); The University of Western Australia, Department of Paediatrics, Perth, Australia (GRID:grid.1012.2) (ISNI:0000 0004 1936 7910)
4 Warwick University, School of Business, Warwick, UK (GRID:grid.7372.1) (ISNI:0000 0000 8809 1613)
5 Monash University, School of Medicine, Melbourne, Australia (GRID:grid.1002.3) (ISNI:0000 0004 1936 7857)
6 Robinson Research Institute, The University of Adelaide, Adelaide, Australia (GRID:grid.1010.0) (ISNI:0000 0004 1936 7304); The University of Adelaide, Adelaide Medical School, Adelaide, Australia (GRID:grid.1010.0) (ISNI:0000 0004 1936 7304); Women’s and Children’s Hospital, Women’s and Babies Division, Adelaide, Australia (GRID:grid.1694.a)
7 Robinson Research Institute, The University of Adelaide, Adelaide, Australia (GRID:grid.1010.0) (ISNI:0000 0004 1936 7304); The University of Adelaide, Adelaide Medical School, Adelaide, Australia (GRID:grid.1010.0) (ISNI:0000 0004 1936 7304); Women’s and Children’s Hospital, Division of Paediatrics, Adelaide, Australia (GRID:grid.1694.a)
8 South Australian Health and Medical Research Institute, Adelaide, Australia (GRID:grid.430453.5) (ISNI:0000 0004 0565 2606); The University of Adelaide, School of Public Health, Adelaide, Australia (GRID:grid.1010.0) (ISNI:0000 0004 1936 7304)
9 Flinders University, Discipline of Public Health, Adelaide, Australia (GRID:grid.1014.4) (ISNI:0000 0004 0367 2697)
10 Flinders University, Discipline of Paediatrics, Adelaide, Australia (GRID:grid.1014.4) (ISNI:0000 0004 0367 2697); SA Health, South Australian Government, Adelaide, Australia (GRID:grid.467022.5) (ISNI:0000 0004 0540 1022)
11 SA Health, South Australian Government, Adelaide, Australia (GRID:grid.467022.5) (ISNI:0000 0004 0540 1022)
12 Flinders University, Discipline of Paediatrics, Adelaide, Australia (GRID:grid.1014.4) (ISNI:0000 0004 0367 2697)
13 Lyell McEwin Hospital, Discipline of Paediatrics, Elizabeth Vale, Australia (GRID:grid.460761.2) (ISNI:0000 0001 0323 4206)
14 Robinson Research Institute, The University of Adelaide, Adelaide, Australia (GRID:grid.1010.0) (ISNI:0000 0004 1936 7304); The University of Adelaide, Adelaide Medical School, Adelaide, Australia (GRID:grid.1010.0) (ISNI:0000 0004 1936 7304); Lyell McEwin Hospital, Discipline of Women’s Health, Elizabeth Vale, Australia (GRID:grid.460761.2) (ISNI:0000 0001 0323 4206)
15 The University of Western Australia, Department of Paediatrics, Perth, Australia (GRID:grid.1012.2) (ISNI:0000 0004 1936 7910)
16 The University of Melbourne, Department of Paediatrics, Melbourne, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X); Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Australia (GRID:grid.416107.5) (ISNI:0000 0004 0614 0346)
17 University of Sydney, Discipline of Paediatrics, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); Children’s Hospital Westmead, Sydney, Australia (GRID:grid.413973.b) (ISNI:0000 0000 9690 854X)
18 Australian National University, Discipline of Public Health, Canberra, Australia (GRID:grid.1001.0) (ISNI:0000 0001 2180 7477)