Enhancing Protection Against Influenza and COVID-19 for Pregnant Women and Medically at Risk Children

Enhancing Protection Against Influenza and COVID-19 for Pregnant Women and Medically at Risk Children

Enhancing Protection Against Influenza and COVID-19 for Pregnant Women and Medically at Risk Children (EPIC Study)

Pregnant women and children with chronic medical conditions are at increased risk of hospitalisation, intensive care admission and death from influenza and COVID-19 infections. However, there appears to be a high level of vaccine hesitancy among women of reproductive age. We will develop "nudge" interventions to improve influenza and COVID vaccine uptake among pregnant women and medically at risk children and test the effectiveness of the interventions using randomised controlled trials.

Pregnant women and children with chronic medical conditions are at an unacceptable risk of hospitalisation and death from influenza and COVID-19 infections. Pregnant women are 3 times more likely to die from COVID-19 and over 7 times more likely to be admitted to an intensive care unit (ICU) with influenza compared to non-pregnant women. Children with chronic disease are already compromised with a higher risk of hospitalisation from influenza and requirement for ICU management and long term disability following COVID-19. Uptake of the recommended influenza vaccine among pregnant women and medically at risk children in Australia is only ~50%. Based on recent surveys, the predicted uptake of COVID-19 vaccine among both groups is also likely to be ~50%. These two groups preferentially receive care from medical specialists (obstetricians and paediatricians) and specialist nursing staff in hospitals, and are less likely to engage with primary care, the usual providers of immunisation. The aim of this project is to develop a nudge (i.e. small changes in the environment that alter people's behaviour) and evaluate the effectiveness of the nudge intervention in improving the uptake of COVID and influenza vaccine among pregnant women and medically at risk children by conducting four randomised control trials.

Women randomized to the intervention group will receive the nudge (three text messages four weeks apart) to remind them to get the COVID-19 booster vaccine

Women randomized to the standard care group will not receive the nudge (three text messages four weeks apart) to remind them to get the COVID-19 booster vaccine. They will receive normal care at the hospital.

Women randomized to the intervention group will receive the nudge (three text messages four weeks apart) to remind them to get the annual influenza vaccine

Women randomized to the standard care group will not receive the nudge (three text messages four weeks apart) to remind them to get the annual influenza vaccine. They will receive normal care at the hospital.

Parents of medically at risk children randomized to the intervention group will receive the nudge (three text messages four weeks apart) to remind them to get their child the COVID-19 vaccine

Parents of medically at risk children randomized to the standard care group will not receive the nudge (three text messages four weeks apart) to remind them to get their child the COVID-19 vaccine. They will receive normal care at the hospital.

Parents of medically at risk children randomized to the intervention group will receive the nudge (three text messages four weeks apart) to remind them to get their child the annual influenza vaccine

Parents of medically at risk children randomized to the standard care group will not receive the nudge (three text messages four weeks apart) to remind them to get their child the annual influenza vaccine. They will receive normal care at the hospital.

The proportion of pregnant women who receive one or more doses of a COVID-19 vaccine during pregnancy

Inclusion Criteria: Pregnant women (COVID RCT) - those who have received 2 or less doses of a recommended COVID-19 vaccine Pregnant women (influenza RCT) - those who have not received the influenza vaccine during pregnancy Medically at risk children (COVID RCT) - those who have received 1 or no dose of a recommended COVID-19 vaccine Medically at risk children(influenza RCT) - those who have not received the annual influenza vaccine Exclusion Criteria: Pregnant women (COVID RCT) - those who have received 3 or more doses of a recommended COVID-19 vaccine Pregnant women (influenza RCT) - those who have received the influenza vaccine during pregnancy Medically at risk children (COVID RCT) - those who have received 2 or more doses of a recommended COVID-19 vaccine Medically at risk children(influenza RCT) - those who have received the annual influenza vaccine