Parents may permit direct reminders to teens 


Frequency of care in pediatric populations tends to wane as children reach adolescence, but a new study investigates whether parents would allow clinicians to reach out to their children by text message to offer important reminders.

James R. Roberts, MD, MPH headshot

James R Roberts, MD, MPH

New research published in the May 2018 issue of Vaccine suggests that text messages sent directly to adolescents by their physicians may provide a new avenue for clinicians to issue reminders for care.1 The study investigated whether parents would allow reminders to be sent to their older teenagers via text message for interventions such as the meningococcal conjugate vaccine (MCV4), the human papillomavirus (HPV) vaccine series, and annual influenza vaccinations.

Surveys were given to parents of 10- to 17-year-old patients across 11 practices in South Carolina and Oklahoma. The surveys polled parents about vaccine reminder preferences for their teenagers, and whether they would be open to direct messaging and, if so, at what age.

The survey found that of 546 parents who completed the survey, 75% of parents of girls supported vaccine reminders by text message directly to the teenager, compared with 60% of parents of boys. In regard to age, the median age at which parents were open to direct text messaging from providers was 14 years in female patients and 15 years in males.

“We found a correlation between the child's age and the youngest age at which parents would allow a direct text message,” the researchers said. “Of the parents who permitted a text message directly to their adolescent, most reported an allowable age higher than their adolescent's current age until the age of 15.”

Care frequency tends to wane as children age, and this becomes a particular challenge when it comes to keeping older pediatric patients up-to-date with necessary vaccinations, the study notes.

Meningococcal vaccine rates in teenagers are around 40%, according to the Centers for Disease Control and Prevention (CDC), and HPV is about 60%. For HPV, however, although many adolescents get their first dose of vaccine, most are not completing the series. According to the CDC, just 43% of teenagers are up-to-date on the entire vaccine series.

Technology may provide another avenue for outreach. James R Roberts, MD, MPH, a professor of Pediatrics at the Medical University of South Carolina, Charleston, and lead author of the study, says there is increasing evidence that patients and parents wish to receive information through text messaging.

“Parents are receptive, to an extent, at having the healthcare provider directly communicate to their teenager. Pediatricians often send reminders to the parents, but not the teen,” Roberts says. “In the future, direct communication to the teen may be a possibility and may even facilitate the transition of care process.”

One limitation of the study was that only parents were polled about the possibility of direct messaging. The study did not investigate whether teenagers would be receptive to messages from clinicians or follow-up with them.

“While we eventually hope that text messaging may be a valid and routine reminder system for older teens for any healthcare issue, we first need to identify limiting factors of how responsive teens would be to the text message reminder,” Roberts says. “It is not yet known if the teens themselves would be as responsive as parents are in keeping or making an appointment for their healthcare or an outstanding immunization.”


Roberts says this study is only a first step to hopefully finding new ways to reach out to this population.




1. Roberts JR, Morella K, Dawley EH, et al. Direct-to-adolescent text messaging for vaccine reminders: What will parents permit? Vaccine. 2018;36(20);2788-2793.

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