Nudging Boosts Flu Vaccine Numbers

Automatic orders and text reminders increased flu shot uptake by 28%

Jan. 27, 2026 at 10:47pm

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A new study from the Perelman School of Medicine found that patients were 28% more likely to get a flu shot when they received a text message reminder and their primary care provider already had an order for the shot waiting. The researchers believe these nudge interventions, which also included monthly messages to providers comparing their vaccination rates to peers, could help boost flu shot uptake and address rising vaccine hesitancy.

Why it matters

Flu hospitalizations have been high in recent years, underscoring the importance of increasing vaccination rates. Many patient-focused nudge interventions have shown limited effectiveness in the U.S., so this study aimed to address both the patient and clinician sides to make getting a flu shot the easiest choice.

The details

The study randomly assigned over 52,000 eligible patients to either receive the full set of nudges or standard care. The nudges included flu shot reminder texts, automatic orders for the shot waiting for clinician approval, and monthly messages to providers comparing their vaccination rates to peers. Researchers found nearly 3,000 more people got flu shots when nudged compared to standard care.

  • The study was published in JAMA Internal Medicine in January 2026.

The players

Shivan Mehta

The study's lead author, associate chief innovation officer at Penn Medicine.

Amol Navathe

A co-senior author, professor of Medical Ethics and Health Policy, and professor of Health Care Management in the Wharton School.

University of Pennsylvania Health System

One of the health systems where the study was conducted.

UW Medicine

The University of Washington's health system, where the other part of the study was conducted.

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What they’re saying

“This is important given the rise in vaccine hesitancy, which has resulted in a downward trend in flu vaccination that coincided with a high rate of hospitalization this flu season.”

— Shivan Mehta, Associate chief innovation officer at Penn Medicine

“We think the automatic order encouraged primary care physicians to have a conversation with their patients, and we know these clinicians still have a lot of trust from their communities.”

— Amol Navathe, Professor of Medical Ethics and Health Policy, and professor of Health Care Management in the Wharton School

What’s next

The team has replicated their work at Lancaster General Health in the University of Pennsylvania Health System, and is still analyzing the results of this replication study.

The takeaway

This study shows that nudging both patients and clinicians can be an effective way to boost flu vaccination rates, which is crucial given the rise in vaccine hesitancy and the serious public health impacts of the flu. The low-cost, scalable nature of these interventions makes them attractive for health systems looking to improve preventive care.