Influenza and Text Messaging in Pregnancy

History and the 2009 H1N1 influenza pandemic suggest that both seasonal and pandemic
influenza infections impart disproportionate morbidity and mortality among gravidas. The
influenza vaccine represents a viable, preventive health intervention to mitigate disease
burden for gravidas and their neonates. Despite the safety and efficacy of influenza
vaccines, suboptimal maternal vaccination rates (13-24%) persist nationwide. Barriers to
influenza vaccination during pregnancy include patient concerns about vaccine safety and
unappreciated risk of influenza infection. Cellular phone text messaging has emerged as an
innovative technology with advantages of ubiquity, rapid, confidential information
transmission, and low cost. Text messaging may represent an effective way to educate pregnant
women about their particular vulnerability to influenza infection and enhance influenza
vaccine uptake. We propose a randomized, controlled clinical trial to assess whether text
messaging to an outpatient obstetric population can improve maternal influenza vaccine
uptake.

Inclusion Criteria:

1. Pregnant women less than 28 weeks estimated gestation age

2. Between 14-50 years of age

3. Willing to provide informed consent and undergo necessary study procedures

Exclusion Criteria:

1. Unwillingness or inability to receive text messages

2. Receipt of the current season's influenza vaccine or plan to receive the influenza
vaccine on the day of the enrollment visit

3. Reported history of adverse reaction precluding receipt of the vaccine

4. Unwillingness or inability to provide informed consent and comply with study criteria.