Nationwide demonstration of improved COVID-19 vaccination uptake through behavioural reminders

Hannah Behrendt (), Giulia Tagliaferri, Lev Tankelevitch, Yihan Xu, Hugo Harper, Natalie Gold, Dale Weston, Rachel Rosen and Robert Scott
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Hannah Behrendt: The Behavioural Insights Team
Giulia Tagliaferri: The Behavioural Insights Team
Lev Tankelevitch: The Behavioural Insights Team
Yihan Xu: The Behavioural Insights Team
Hugo Harper: The Behavioural Insights Team
Natalie Gold: London School of Economics and Political Science
Dale Weston: UK Health Security Agency
Rachel Rosen: NHS England
Robert Scott: NHS England

Nature Human Behaviour, 2025, vol. 9, issue 6, 1237-1245

Abstract: Abstract Here we report the results of two nationwide randomized controlled trials. By refining behavioural-science-informed text messages notifying patients of their vaccine eligibility, we observed improvements in vaccination rates. The randomized controlled trials involved adults aged 40–44 years (n = 1,825,937) and 24–29 years (n = 2,174,064) in England. Messages emphasizing ‘Top of queue’ status led to small, but policy-relevant, increases in vaccination rates in both the 40–44 age group (odds ratio 1.02, 95% confidence interval 1.01–1.03) and the 24–29 age group (odds ratio 1.02, 95% confidence interval 1.01–1.04). Consequently, the ‘Top of queue’ message was nationally rolled out to other age groups. These findings demonstrate the potential of ‘queue’ framing in relevant contexts and the value of rigorous testing of public health messaging.

Date: 2025
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DOI: 10.1038/s41562-025-02165-x

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