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Influenza Vaccination With Electronic Nudges Does Not Improve Clinical Outcomes

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Influenza Vaccination With Electronic Nudges Does Not Improve Clinical Outcomes

(CTN News) – A study published in the Annals of Internal Influenza Medicine found that incorporating cardiovascular (CV) gains into electronic letters, which are intended to increase influenza vaccination, did not lead to improved clinical outcomes.

An article by Niklas Dyrby Johansen, MD, at Copenhagen University Hospital-Herlev and Gentofte in Denmark, and colleagues examined the effects of the successful nudging interventions that were implemented in the nationwide Utilization of Danish Government Electronic letter system to increase vaccination uptake in the inFLUenza vaccine trial (NUDGE-FLU) in the 2022 to 2023 influenza season on downstream clinical outcomes.

We analysed data collected from 964,870 Danish citizens aged 65 years and older who received either usual care or nine different behavioral nudging letters delivered electronically; the analysis set included 691,820 individuals in total.

Among the participants in the usual-care group, 1.0 percent of those in the CV gain-framing group, and 1.1 percent of those in the repeated-letter group had been hospitalized for pneumonia or influenza in the past year.

A total of 12.9, 13.0, and 13.0 percent of the participants in the usual-care group, the CV gain-framing group, and the repeated-letter group were hospitalized for any reason, respectively, when compared to the usual-care group.

Additionally, no significant differences were observed between the usual-care, CV gain-framing, and repeated-letter groups as far as mortality is concerned, with 1.8, 1.9, and 1.7 percent of participants dying from the various interventions.

A small increase in influenza vaccination rates was seen with electronic nudging letters, but the authors state that no observable improvements in clinical outcomes were seen as a result of these increases.


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Alishba Waris is an independent journalist working for CTN News. She brings a wealth of experience and a keen eye for detail to her reporting. With a knack for uncovering the truth, Waris isn't afraid to ask tough questions and hold those in power accountable. Her writing is clear, concise, and cuts through the noise, delivering the facts readers need to stay informed. Waris's dedication to ethical journalism shines through in her hard-hitting yet fair coverage of important issues.

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