Efficacy of text message intervention for increasing MMR uptake in light of the recent loss of UK’s measles-free status

Public Health England (PHE) recommends that children should receive two doses of MMR vaccine, with the first dose at 12 months of age, and the second dose at 3 years and 4 months of age. In 2019, the UK lost its World Health Organization ‘measles-free’ status, following a 4-year period in which MMR uptake declined.¹ Indeed, ‘suboptimal uptake’, particularly of the second dose, has been identified as the most important factor by the PHE.² We conducted a full cycle audit of a single practice using a text message intervention, which increased uptake of the MMR vaccine over a 5-month period.

The patient database was searched to determine children aged 3–11 years (n = 1447) who have received 0, 1, or 2 MMR vaccinations. The lower age boundary was chosen as children are advised to be vaccinated by 3 years and 4 months, prior to commencing school. The upper boundary represented the age within which our practice had permission to send text messages to the respective parents. In August 2019, 8.98% (n = 130) of patients had only received one MMR vaccination, and 3.73% (n = 54) of patients had received none. The parents of the 184 patients who were not fully vaccinated were sent a text message stating that the UK is no longer measles free, reminding them to book an appointment for vaccination.

From August 2019 to January 2020, 76 patients from the cohort receiving the text message had contacted the practice to receive one or two MMR vaccinations. Fully vaccinated patients increased from 87.28% (n = 1263) to 92.47% (n = 1338).

In the audit period, the population of 3–11-year-olds registered at the practice changed. Our intervention was not implemented for children who turned 3 years old during the audit period, or for newly registered patients (n = 117). Patients no longer in the age range or who had left the practice (n = 67) were also not included. Additionally, our audit does not take into account the baseline uptake rate of the MMR vaccination.

In sum, text message interventions are cost-effective, accessible, and instantaneous for disseminating health information. We recommend the use of text messages for patient notification to improve uptake of the MMR vaccine.