A Mega-Study of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor’s Appointment
75 Pages Posted: 19 Feb 2021 Last revised: 5 May 2021
Katherine L. Milkman
University of Pennsylvania - The Wharton School
Mitesh S. Patel
University of Pennsylvania - Perelman School of Medicine, Department of Medicine
Linnea Gandhi
University of Pennsylvania
Heather Graci
University of Pennsylvania
Dena Gromet
University of Pennsylvania
Hung Ho
University of Pennsylvania - Operations & Information Management Department
Joseph Kay
University of Pennsylvania
Timothy Lee
University of Pennsylvania
Modupe Akinola
Columbia University - Columbia Business School
John Beshears
Harvard University - Business School (HBS); National Bureau of Economic Research (NBER)
Jon Bogard
University of California, Los Angeles (UCLA), Anderson School of Management, Students
Alison Buttenheim
University of Pennsylvania
Christopher Chabris
Geisinger Health System
Gretchen B. Chapman
Rutgers, The State University of New Jersey
James J. Choi
Yale School of Management; National Bureau of Economic Research (NBER)
Hengchen Dai
University of California, Los Angeles (UCLA) - Anderson School of Management
Craig R. Fox
University of California, Los Angeles (UCLA) - Anderson School of Management
Amir Goren
Geisinger Health System
Matthew Hilchey
University of Toronto - Faculty of Kinesiology and Physical Education
Jillian Hmurovic
University of Pennsylvania - The Wharton School
Leslie John
Harvard University - Business School (HBS)
Dean Karlan
Northwestern University
Melanie Kim
University of Toronto
David Laibson
Harvard University - Department of Economics; National Bureau of Economic Research (NBER)
Cait Lamberton
The Wharton School
Brigitte C. Madrian
Brigham Young University Marriott School of Business; National Bureau of Economic Research (NBER)
Michelle N. Meyer
Clarkson University–Icahn School of Medicine at Mount Sinai Bioethics Program; Geisinger Health System, Center for Translational Bioethics and Health Care Policy
Maria Modanu
Columbia University
Jimin Nam
Harvard Business School
Todd Rogers
Harvard University - Harvard Kennedy School (HKS)
Renante Rondina
University of Toronto - Rotman School of Management
Silvia Saccardo
Carnegie Mellon University, Department of Social and Decision Sciences
Maheen Shermohammed
Geisinger Health System
Dilip Soman
University of Toronto - Behavioural Economics in Action at Rotman (BEAR)
Jehan Sparks
University of California, Los Angeles (UCLA)
Caleb Warren
University of Arizona
Megan Weber
University of California, Los Angeles (UCLA)
Ron Berman
University of Pennsylvania - The Wharton School
Chalanda Evans
University of Pennsylvania - Perelman School of Medicine
Christopher Snider
University of Pennsylvania - Perelman School of Medicine
Eli Tsukayama
University of Hawaii at West O'ahu
Christophe Van den Bulte
University of Pennsylvania - Marketing Department
Kevin Volpp
University of Pennsylvania - Perelman School of Medicine, Department of Medicine
Angela Duckworth
University of Pennsylvania - Department of Psychology
Date Written: January 27, 2021
Abstract
Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N=47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were (a) framed as reminders to get flu shots that were already reserved for the patient and (b) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor’s appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.
Keywords: vaccination, COVID-19, nudge, influenza, field experiment
JEL Classification: I12
Suggested Citation: Suggested Citation
Mitesh S. Patel
University of Pennsylvania - Perelman School of Medicine, Department of Medicine
Philadelphia, PA 19104
United States
Linnea Gandhi
University of Pennsylvania ( email )
Philadelphia, PA 19104
United States
Heather Graci
University of Pennsylvania ( email )
Philadelphia, PA 19104
United States
Dena Gromet
University of Pennsylvania ( email )
Philadelphia, PA 19104
United States
Quoc Dang Hung Ho

University of Pennsylvania - Operations & Information Management Department ( email )
Philadelphia, PA 19104
United States
Joseph Kay
University of Pennsylvania ( email )
Philadelphia, PA 19104
United States
Timothy Lee
University of Pennsylvania ( email )
Philadelphia, PA 19104
United States
Modupe Akinola

Columbia University - Columbia Business School ( email )
3022 Broadway
New York, NY 10027
United States
John Beshears

Harvard University - Business School (HBS) ( email )
Soldiers Field Road
Morgan 270C
Boston, MA 02163
United States
National Bureau of Economic Research (NBER) ( email )
1050 Massachusetts Avenue
Cambridge, MA 02138
United States
Jonathan Bogard
University of California, Los Angeles (UCLA), Anderson School of Management, Students ( email )
Los Angeles, CA
United States
Alison Buttenheim
University of Pennsylvania
Philadelphia, PA 19104
United States
Christopher Chabris
Geisinger Health System ( email )
120 Hamm Drive, Suite 2A, MC 60-36
Lewisburg, PA 17837
United States
HOME PAGE: http://www.chabris.com
Gretchen B. Chapman
Rutgers, The State University of New Jersey ( email )
311 North 5th Street
New Brunswick, NJ 08854
United States
James J. Choi

Yale School of Management ( email )
135 Prospect Street
P.O. Box 208200
New Haven, CT 06520-8200
United States
National Bureau of Economic Research (NBER) ( email )
1050 Massachusetts Avenue
Cambridge, MA 02138
United States
Hengchen Dai
University of California, Los Angeles (UCLA) - Anderson School of Management ( email )
110 Westwood Plaza
Los Angeles, CA 90095-1481
United States
Craig R. Fox
University of California, Los Angeles (UCLA) - Anderson School of Management ( email )
110 Westwood Plaza
Los Angeles, CA 90095-1481
United States
Amir Goren
Geisinger Health System ( email )
100 North Academy Ave.
Danville, PA 17822-4910
United States
Matthew Hilchey
University of Toronto - Faculty of Kinesiology and Physical Education ( email )
Jillian Hmurovic

University of Pennsylvania - The Wharton School ( email )
3641 Locust Walk
Philadelphia, PA 19104-6365
United States
Leslie John
Harvard University - Business School (HBS)
Boston, MA 02163
United States
Dean Karlan
Northwestern University ( email )
2001 Sheridan Road
Evanston, IL 60208
United States
Melanie Kim
University of Toronto ( email )
105 St George Street
Toronto, Ontario M5S 3G8
Canada
David I. Laibson
Harvard University - Department of Economics ( email )
Littauer Center
Room M-14
Cambridge, MA 02138
United States
617-496-3402 (Phone)
617-495-8570 (Fax)
National Bureau of Economic Research (NBER) ( email )
1050 Massachusetts Avenue
Cambridge, MA 02138
United States
Cait Lamberton
The Wharton School ( email )
700 Jon M. Huntsman Hall
3730 Walnut Street
Philadelphia, PA
United States
4127797280 (Phone)
19104 (Fax)
Brigitte C. Madrian
Brigham Young University Marriott School of Business ( email )
Provo, UT 84602
United States
National Bureau of Economic Research (NBER) ( email )
1050 Massachusetts Avenue
Cambridge, MA 02138
United States
Michelle N. Meyer
Clarkson University–Icahn School of Medicine at Mount Sinai Bioethics Program ( email )
80 Nott Terrace
Schenectady, NY 12308
United States
HOME PAGE: http://www.michellenmeyer.com
Geisinger Health System, Center for Translational Bioethics and Health Care Policy ( email )
100 North Academy Ave.
Danville, PA 17822-4910
United States
HOME PAGE: http://www.michellenmeyer.com
Maria Modanu
Columbia University ( email )
3022 Broadway
New York, NY 10027
United States
Todd Rogers
Harvard University - Harvard Kennedy School (HKS) ( email )
79 John F. Kennedy Street
Cambridge, MA 02138
United States
Renante Rondina

University of Toronto - Rotman School of Management ( email )
105 St. George Street
Toronto, Ontario M5S 3E6 M5S1S4
Canada
Silvia Saccardo
Carnegie Mellon University, Department of Social and Decision Sciences ( email )
Pittsburgh, PA 15213-3890
United States
Maheen Shermohammed
Geisinger Health System ( email )
100 North Academy Ave.
Danville, PA 17822-4910
United States
Dilip Soman

University of Toronto - Behavioural Economics in Action at Rotman (BEAR) ( email )
Jehan Sparks
University of California, Los Angeles (UCLA) ( email )
405 Hilgard Avenue
Box 951361
Los Angeles, CA 90095
United States
Caleb Warren
University of Arizona ( email )
McClelland Hall
P.O. Box 210108
Tucson, AZ 85721-0108
United States
Megan Weber
University of California, Los Angeles (UCLA) ( email )
405 Hilgard Avenue
Box 951361
Los Angeles, CA 90095
United States
Ron Berman

University of Pennsylvania - The Wharton School ( email )
3641 Locust Walk
Philadelphia, PA 19104-6365
United States
Chalanda Evans
University of Pennsylvania - Perelman School of Medicine ( email )
423 Guardian Drive
Philadelphia, PA 19104
United States
Christopher Snider
University of Pennsylvania - Perelman School of Medicine ( email )
423 Guardian Drive
Philadelphia, PA 19104
United States
Eli Tsukayama
University of Hawaii at West O'ahu ( email )
91-1001 Farrington Highway
Kapolei, HI 96707
United States
Christophe Van den Bulte

University of Pennsylvania - Marketing Department ( email )
700 Jon M. Huntsman Hall
3730 Walnut Street
Philadelphia, PA 19104-6340
United States
Kevin Volpp
University of Pennsylvania - Perelman School of Medicine, Department of Medicine ( email )
Philadelphia, PA 19104
United States
Angela Duckworth
University of Pennsylvania - Department of Psychology ( email )
3815 Walnut Street
Philadelphia, PA 19104-6196
United States
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