(HealthDay News) — An individual email nudge can increase COVID-19 vaccination registration among health care workers, according to a research letter published online in JAMA Network Open.

Henri C. Santos, PhD, from Geisinger Health System in Danville, Pennsylvania, and colleagues assessed whether individually addressed emails designed with behaviorally informed features could increase vaccination registration compared to a delayed control group. The analysis included 9457 employees with valid email addresses who had not scheduled a COVID-19 vaccination. Employees were randomly assigned to a control condition or to receive 1 of 2 individually addressed emails either framing the decision to vaccinate around social norms or reframing risks.

The researchers found that both behaviorally informed email types led to more registrations in the first 3 days than the delayed condition (delayed control group: percentage of participants registering, 3.17%; social norms: percentage of participants registering, 6.47%; odds ratio [OR], 2.11 [95% confidence interval (CI), 1.65 to 2.69; P <.001]; reframing risks: percentage of participants registering, 6.90%; OR, 2.26 [95 percent CI, 1.77 to 2.87; P <.001]). Between the 2 email message types, there was no significant difference in registrations (OR, 1.07; 95 percent CI, 0.88 to 1.30; P =.50). Among health care workers not registering for a vaccine but who completed a survey (1229), unknown vaccine risks (35%) and pregnancy-related concerns (13%) were the most commonly cited reasons.


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“Sending targeted emails, patient portal messages, or text messages designed with behavioral science is inexpensive, scalable, and easily implemented and could be an effective way to encourage vaccination by health care workers and the general public,” the authors write.

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