Flu season outreach has a short window, and it’s open right now. Adult flu vaccination coverage fell to 41.9% in the 2024 to 2025 season, the lowest in seven seasons, while that same season caused up to 1.1 million hospitalizations (CDC). CDC calls September and October the ideal months to vaccinate, so practices that wait for the first positive tests are already behind. This guide covers building a flu shot reminder text campaign: who to message first, what to say, and when to send it.
Key Takeaways
- Adult flu vaccination dropped to 41.9% last season, and adults 65 and older accounted for 57% of flu hospitalizations (CDC).
- In a 47,306-patient trial, text reminders sent before a primary care visit raised flu vaccination by about 5%, and the best message said the shot was reserved for the patient (PNAS, 2021).
- Message high-risk patients first, in their language, with an offer to book right in the text thread, then widen to the full panel.
- A four-wave cadence from mid September through December, with suppression for patients already vaccinated, gets the most shots with the fewest messages.
Why Do Flu Shot Reminders Work Better by Text?
Text works because it gets read and removes the next step. Texts carry a 98% open rate, and 93% of Americans have opted in to healthcare texts. A postcard can’t book an appointment. A phone call reaches voicemail.
The evidence is unusually strong. A megastudy of 47,306 primary care patients at Penn Medicine and Geisinger tested 19 text nudges before an upcoming appointment. On average the texts raised flu vaccination by 2.1 percentage points, about 5%, and the top performer reminded patients twice that a flu shot was reserved for them (Milkman et al., PNAS, 2021). A second megastudy of 689,693 Walmart pharmacy patients found reminder texts lifted vaccination 6.8%, with the best messages saying a shot was waiting (PNAS, 2022).
Two lessons carry over. Frame the shot as reserved and match the tone patients expect from their provider, since clever or casual messages underperformed. And end every message with an offer to book, so the patient can reply and pick a time while the phone is still in their hand.
Who Should You Reach First?
Reach the patients most likely to be hospitalized first, then everyone else. Wave one should cover:
- Adults 65 and older, who made up 57% of flu hospitalizations last season (CDC)
- Patients with chronic conditions such as diabetes, heart disease, asthma, COPD, and kidney disease
- Pregnant patients
- Children 6 months through 4 years, by messaging parents
- Immunocompromised patients and residents of long-term care settings
Next come patients with an appointment in the next 30 days, who get the reserved-for-you message, then the rest of the panel. Before any wave goes out, suppress patients who already show a current-season flu vaccine in the EHR, state registry, or pharmacy data, and segment by preferred language. Risk stratification and care gap outreach tools do this automatically, and the same lists power the preventive screening campaigns primary care practices already run.
What Should a Flu Shot Reminder Text Say?
A good flu shot reminder text identifies the practice, makes the ask in one sentence, invites a reply to book, and includes opt-out language. Five examples:
- High-risk first touch: “Hi [Name], it’s [Practice]. Because of your age or health history, a flu shot is especially important this year. We have doses available now. Would you like to book a quick visit now? Reply STOP to opt out.”
- Pre-appointment (reserved): “[Name], a flu shot is reserved for you at your visit with Dr. [Name] on [date]. Reply YES to add it, or NO if you’ve already had one this season.”
- General panel: “It’s flu season, and [Practice] has flu shots available now. No appointment needed Tuesdays and Thursdays until 6 pm. Would you like to book a quick visit now?”
- Nonresponder follow-up: “[Name], a quick reminder from [Practice]: flu shots are still available, and October is the best month to get one before the season peaks. Would you like to book a quick visit now?”
- Late season: “Flu activity is rising in [County]. It’s not too late to get protected. [Practice] has same-week openings. Would you like to book a quick visit now?”
Keep messages short, leave out diagnosis details, and send each in the patient’s language. Let the two-way text conversation offer available times and handle the follow-up questions, like whether the shot costs anything, without pulling staff off the phones.
What Cadence Gets the Best Results?
Four waves over roughly 12 weeks, with suppression between each:
- Wave 1, mid September: high-risk segments and parents of young children.
- Wave 2, early October: the rest of the panel, plus the reserved-for-you message to anyone with an appointment in the next 30 days, repeated once 24 hours before the visit.
- Wave 3, late October: nonresponders only, framed around getting protected before the end of October.
- Wave 4, mid November through December: late catch-up tied to local flu activity. Flu commonly peaks between December and February, so this wave still matters.
A few rules keep the campaign welcome rather than annoying. Never resend to a patient who booked, replied, or now shows a vaccination in the chart. Cap unsolicited touches at three per patient per season. And report weekly on messages delivered, replies, bookings, and shots given, the same discipline behind an evidence-based outreach cadence. HealthTalk A.I.’s broadcast messaging handles the scheduling, opt-out management, and response tracking for flu shot reminders across an entire patient population.
Launch Before the Season Peaks
The practices that vaccinate the most patients reach every high-risk patient in September, make booking as easy as replying to a text, and keep asking politely until the answer is yes.
See how HealthTalk A.I. runs flu shot reminder campaigns across your whole panel.
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