A comment in The Lancet Rheumatology by Bateman and others published June 2021 suggests that specialist advice is required to improve the uptake of COVID-19 vaccines.  

They particularly looked at patients with autoimmune rheumatic diseases.  

Evidence suggests that vaccine uptake in these patients can be improved by more than 20% with physician recommendation, and it is increasingly recognised that timely specialist input is required. 

Low confidence in vaccine safety has been the main factor that has hindered vaccine uptake in patients with rheumatic disease. 

Previous work has shown the utility of mobile SMS for the rapid distribution of urgent healthcare communications.  

As such, the author’s developed a multimedia video message focused on vaccine education that was distributed by mobile SMS messaging, a successful and well-established method of communication in their rheumatology follow up cohort of more than 10,000 patients. 

They developed an eight minute interactive web-based educational video that was designed for mobile phones.  

The video included UK information on:

  • Current licensed COVID-19 vaccines 
  • Vaccination scheduling 
  • Safety
  • Frequently asked questions 
  • Links to established resources.

They sent out SMS messages containing the video link on December 21st 2020 to 8,886 patients who had a valid mobile phone number on their system.  

After 14 days they had had 2358 video views, 27% and 661 patients completed the evaluation.  

Pre intervention 36% of patients aged 30-49 years reported being aware that the vaccine was safe and recommended for them compared with 47% of patients aged 50-69 years and 52% of patients aged 70 years or older.  

The educational video significantly increased these percentages to 88% in patients aged 30-49 years, 92% in patients aged 50-69 and 94% in those age 70 years or old.  

They received no responses from recipients aged 18-29.  

They found that patients felt better informed about the vaccine, more confident about receiving the vaccine and learnt more about the safety of vaccine and were more likely to seek vaccination as a result of this interactive video. 

Older patients learnt significantly more about the vaccine aged 50-69 than those aged 30-49 and these older patients were more confident about having the vaccine and were more likely to have the vaccine.  Interestingly, the results were not affected by sex or rheumatic disease diagnosis. 

The data showed that their vaccine information video was highly effective at addressing misconceptions around vaccination and have the greatest effect in patients age 70 years or older, who constituted an at risk group.  

It has been thought previously that digital accessibility in the older age groups was going to be a barrier.  

However, the older cohort appeared equally able to access healthcare communications on their mobile phones, which probably reflects the shift to using digital technology in this age group as in the general population.  

Patients completing the evaluation were generally representative of their patient population.  

The youngest patients return no evaluations, which might relate to a range of factors including the suggested long wait for vaccination in this age group in the UK at the time of distribution of the video.  

The authors concluded that this was the first published intervention using a targeted COVID-19 vaccine education video and the first to be delivered to patients with autoimmune rheumatic disease.  

Their findings echoed those of others who have reported low awareness of vaccine information and safety.  

Crucially, the oldest age group, which constituted the most at risk population, found the video most informative and were more likely than those in the younger age group to change their behaviour as a result.  

This paper added to the evidence supporting SMS links technology in distributing targeted patient educational materials and its role in a pandemic. 

The London General Practice is proud to commend the Government on its vaccination programme and urges all those who are offered to uptake the vaccine.

Dr Paul Ettlinger

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