Background: Influenza remains a significant health problem in early childhood, with vaccination uptake still below optimal levels. This study assessed the effectiveness of a combined digital and active reminder intervention in promoting influenza vaccination among children aged 6 months to 6 years. Methods: A prospective observational study enrolled 792 eligible children, aged 6 months to 6 years, in a pediatric primary care practice within the Italian National Health Service, Local Health Unit Bari (LHU BA). Parents received web-based informational content about influenza vaccination and personalized vaccination reminders. Vaccination coverage, uncomplicated Influenza-Like Illnesses (ILI), and confirmed influenza cases were monitored. Results: Out of 792 eligible children, 375 (47.4%) adhered to the campaign; 358 (95.5%) completed the full vaccination schedule. 17 children were partially vaccinated with the intramuscular vaccine due to lack of doses. Intramuscular vaccine was administered to 281 children (74.9%), and intranasal to 94 (25.1%). Vaccination coverage was significantly higher than both the local health district (LHU BA, 33.1%) and the regional one (Puglia, 29.7%) (p < 0.001). A total of 259 ILI episodes were registered: 94 among fully vaccinated children, 160 among unvaccinated children, and 5 in partially vaccinated children. 169 rapid flu tests were performed: 75 in fully vaccinated, 89 in unvaccinated, and 5 in partially vaccinated children. Influenza was confirmed in 7 fully vaccinated children (1 intranasal, 6 intramuscular), 41 unvaccinated, and 4 partially vaccinated children. Vaccination was significantly associated with lower odds of influenza (OR = 0.15; 95% CI: 0.06-0.36; p < 0.001), corresponding to a vaccine effectiveness of 85%. Conclusions: The intervention improved vaccination coverage compared to regional and local benchmarks. Vaccinated children showed both a lower incidence of ILI and confirmed influenza cases, supporting the potential of digital strategies in enhancing pediatric flu vaccination programs.

Effectiveness of a digital communication and active recall strategy to improve pediatric influenza vaccination in primary care: a prospective observational study

Farella, Ilaria
;
2026-01-01

Abstract

Background: Influenza remains a significant health problem in early childhood, with vaccination uptake still below optimal levels. This study assessed the effectiveness of a combined digital and active reminder intervention in promoting influenza vaccination among children aged 6 months to 6 years. Methods: A prospective observational study enrolled 792 eligible children, aged 6 months to 6 years, in a pediatric primary care practice within the Italian National Health Service, Local Health Unit Bari (LHU BA). Parents received web-based informational content about influenza vaccination and personalized vaccination reminders. Vaccination coverage, uncomplicated Influenza-Like Illnesses (ILI), and confirmed influenza cases were monitored. Results: Out of 792 eligible children, 375 (47.4%) adhered to the campaign; 358 (95.5%) completed the full vaccination schedule. 17 children were partially vaccinated with the intramuscular vaccine due to lack of doses. Intramuscular vaccine was administered to 281 children (74.9%), and intranasal to 94 (25.1%). Vaccination coverage was significantly higher than both the local health district (LHU BA, 33.1%) and the regional one (Puglia, 29.7%) (p < 0.001). A total of 259 ILI episodes were registered: 94 among fully vaccinated children, 160 among unvaccinated children, and 5 in partially vaccinated children. 169 rapid flu tests were performed: 75 in fully vaccinated, 89 in unvaccinated, and 5 in partially vaccinated children. Influenza was confirmed in 7 fully vaccinated children (1 intranasal, 6 intramuscular), 41 unvaccinated, and 4 partially vaccinated children. Vaccination was significantly associated with lower odds of influenza (OR = 0.15; 95% CI: 0.06-0.36; p < 0.001), corresponding to a vaccine effectiveness of 85%. Conclusions: The intervention improved vaccination coverage compared to regional and local benchmarks. Vaccinated children showed both a lower incidence of ILI and confirmed influenza cases, supporting the potential of digital strategies in enhancing pediatric flu vaccination programs.
2026
Active recall
Digital health tools
Influenza vaccination
Pediatric primary care
Reminder systems
Social media
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12572/35010
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