What is it about?

We used qualitative descriptive analysis to understand 17,090 unsolicited text message replies we got to our COVID-19 vaccination digital health intervention. What did people tell us, when we didn't ask them to tell us anything? For the most part, that they already were vaccinated (31.1%) or that they wanted to unsubscribe (25.4% [the reason we read these messages is because they misspelled STOP or added more words]). Another 18.3% sent what we considered benign replies, like "thank you" and “❤.” The 12.7% who replied that they wouldn't get vaccinated ranged from the polite decliners to the angry. Their replies provide rich insights into people's reasons for not receiving COVID-19 vaccination that can inform both future iterations of our Precision Nudging intervention as well as other interventions focused on motivating COVID-19 vaccination.

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Why is it important?

A heartening discovery was that about a third of the text messages were letting the health system know the recipient had already been vaccinated elsewhere. Many of these folks expressed thanks that they'd been offered a vaccination. Another third were typos, auto-responses, and wrong numbers. The remaining third were varieties of "no thank you" ranging from polite to... well, not so polite. We also looked at whether response types were sent proportionally to different groups' representations in the patient population. We found that older and African American patients were more likely to respond that they'd already been vaccinated than suggested by their base rate in the population, while younger and white people were more likely to share negative responses than expected from base rates. We speculate that early campaigns to get older adults vaccinated were effective in shaping positive receptions, while racial disparities in vaccination rates likely owe much to structural inequities and access limitations.

Perspectives

This research has been such a labor of love. We read every single SMS reply, which you can imagine was emotionally difficult at times. But it was worth it: there is a richness and depth of qualitative research that I think add tremendous value to our understanding of why some people decline COVID vaccination.

E. Susanne Blazek
Behavioral Reinforcement Learning Lab (BReLL), Lirio

Read the Original

This page is a summary of: Responses to a COVID-19 vaccination intervention: Qualitative analysis of 17K unsolicited SMS replies., Health Psychology, July 2023, American Psychological Association (APA),
DOI: 10.1037/hea0001297.
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