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. 2025 Mar 3;8(3):e250320.
doi: 10.1001/jamanetworkopen.2025.0320.

COVID-19 Outcomes Among Adults Receiving Electronic Nudges to Increase Influenza Vaccination: A Prespecified Secondary Analysis of the NUDGE-FLU Trial

Niklas Dyrby Johansen  1   2   3 , Ankeet S Bhatt  4   5   6 , Brian L Claggett  3 , Erica L Dueger  7 , Scott D Solomon  3 , Muthiah Vaduganathan  3   6 , Tor Biering-Sørensen  1   2   8
Affiliations

COVID-19 Outcomes Among Adults Receiving Electronic Nudges to Increase Influenza Vaccination: A Prespecified Secondary Analysis of the NUDGE-FLU Trial

Niklas Dyrby Johansen et al. JAMA Netw Open. .
No abstract available

Plain language summary

This secondary analysis of a randomized clinical trial investigates whether electronic nudging letters to increase influenza vaccination have an effect on COVID-19 vaccination, infection, and hospitalization.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Bhatt reported personal fees from Sanofi Pasteur outside the submitted work. Dr Claggett reported personal fees for statistical consulting from Alnylam, Cardior, Cardurion, Cytokinetics, CVRx, Intellia, Rocket, and Eli Lilly outside the submitted work. Dr Dueger reported being a Sanofi employee and may hold shares and/or stock options in the company. Dr Solomon reported grants from Alexion, Alnylam, Applied Therapeutics, AstraZeneca, Bellerophon, Bayer, BMS, Boston Scientific, Cytokinetics, Edgewise, Eidos/BridgeBio, Gossamer, GSK, Ionis, Lilly, NIH/NHLBI, Novartis, NovoNordisk, Respicardia, Sanofi Pasteur, Tenaya, Theracos, US2.AI (grant to institution) and personal fees from Abbott, Action, Akros, Alexion, Alnylam, Amgen, Arena, AstraZeneca, Bayer, BMS, Cardior, Cardurion, Corvia, Cytokinetics, GSK, Intellia, Lilly, Novartis, Roche, Theracos, Quantum Genomics, Tenaya, Sanofi-Pasteur, Dinaqor, Tremeau, CellProThera, Moderna, American Regent, Sarepta, Lexicon, Anacardio, Akros, and Valo (consulting) outside the submitted work. Dr Vaduganathan reported research grant support, served on advisory boards, or had speaker engagements from American Regent, Amgen, AstraZeneca, Bayer AG, Baxter Healthcare, BMS, Boehringer Ingelheim, Chiesi, Cytokinetics, Fresenius Medical Care, Idorsia Pharmaceuticals, Lexicon Pharmaceuticals, Merck, Milestone Pharmaceuticals, Novartis, Novo Nordisk, Pharmacosmos, Relypsa, Roche Diagnostics, Sanofi, and Tricog Health; and clinical trial committees from Amgen, AstraZeneca, Galmed, Novartis, Bayer AG, Occlutech, and Impulse Dynamics outside the submitted work. Dr Biering-Sørensen reported grants from Sanofi Pasteur (research grant), personal fees from Sanofi Pasteur (consulting fees and lecture fees), grants from Novo Nordisk (research grant), personal fees from Novo Nordisk (consulting fees), grants from Novartis (research grant), personal fees from Novartis (lecture fee), grants from Pfizer (research grant), grants from GSK (research grant), personal fees from GSK (consulting fees and lecture fees), grants from AstraZeneca (research grant), grants from Boston Scientific (research grant), grants from GE Healthcare (research grant), personal fees from IQVIA (consulting fee), personal fees from Parexel (consulting fee), personal fees from Amgen (consulting fee), personal fees from CSL Seqirus (consulting fee), personal fees from AstraZeneca (lecture fee), personal fees from Bayer (lecture fee), and personal fees from GE Healthcare (lecture fee) outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Effects of Electronic Letters to Increase Influenza Vaccination on COVID-19 Vaccination Rates
NUDGE-FLU used an analytical set containing one randomly selected participant per household (n = 691 820). Differences in COVID-19 vaccination rates were tested using χ2 tests.
Figure 2.
Figure 2.. Cumulative Incidence Curves for COVID-19–Related Clinical Outcomes
Laboratory-confirmed COVID-19 (A) and COVID-19 hospitalization (B) were considered as first-event end points, displayed as cumulative incidence curves, and modeled using Cox proportional hazards models. HR indicates hazard ratio.
See this image and copyright information in PMC

References

    1. World Health Organization . Global influenza strategy 2019-2030. World Health Organization. 2019. Accessed December 20, 2022. https://apps.who.int/iris/handle/10665/311184
    1. CDC . Flu vaccination coverage, United States, 2022–23 influenza season | FluVaxView | seasonal influenza (flu). Published October 10, 2023. Accessed November 27, 2023. https://www.cdc.gov/fluvaxview/coverage-by-season/2022-2023.html
    1. Johansen ND, Vaduganathan M, Bhatt AS, et al. Electronic nudges to increase influenza vaccination uptake among patients with heart failure: a pre-specified analysis of the NUDGE-FLU trial. Eur J Heart Fail. 2023;25(8):1450-1458. doi: 10.1002/ejhf.2913 - DOI - PubMed
    1. Johansen ND, Vaduganathan M, Bhatt AS, et al. Electronic nudges to increase influenza vaccination uptake in Denmark: a nationwide, pragmatic, registry-based, randomised implementation trial. Lancet. 2023;401(10382):1103-1114. doi: 10.1016/S0140-6736(23)00349-5 - DOI - PubMed
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