Text message reminders increased human papillomavirus (HPV) vaccination rates among adolescents, the according to the results of a new study. Because HPV is the most common sexual transmitted infection (STI) among teens in the US, this study was designed to examine the efficacy of text message reminder systems in order to improve HPV vaccination rates in this age group.

“Implementing text message reminder systems in clinical practices is a simple but effective and sustainable process to increase HPV vaccination rates and ultimately decrease HPV-associated cancers,” said lead author, Sonya Khuwaja, DNP, APRN, FNP-C. “Pediatric-focused advanced practice registered nurses can play a leading role in implementing this critical health promotion service.”

Vaccines to prevent HPV have been available since 2006 and are universally recommended. A 2-dose series, with each dose given in a 6- to 12-month interval, is recommended for children up to 15 years of age. A 3-dose series, with 1 to 2 months between the first and second doses and the third dose given 3 months later, is recommended for individuals 15 to 26 years of age.

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Study authors conducted a literature review using Cumulative Index to Nursing and Allied Health Literature and PubMed databases to search for articles published between 2011 and 2021 examining the effects of text message reminders for HPV vaccination. Main inclusion criteria for the study were patients aged 9 to 26 years who were due for the HPV vaccine (first or subsequent dose).

They identified 41 articles, which were then narrowed down to 7 peer-reviewed articles that met all inclusion criteria. “All 7 studies also had an intervention group that received various frequencies of text messages at different times as a reminder for each dose,” the researchers explained.

Study Finding Excerpts

Among the studies that examined the effect of text message content on HPV vaccination rates, one study found that texts providing content on sexual health practices but centered on detailed HPV vaccination information, including motivation to foster vaccine uptake, were linked to a 3-fold increase in initial series rates compared with texts providing basic information on HPV vaccination and emphasized a variety of sexual health practices. Another study found that that patients who received self-regulatory text messages or motivational message elicited significantly higher vaccination rates compared with participants who received no message.

The study authors also evaluated whether text message reminders affected the timeliness of the participants receiving the subsequent dose of the HPV vaccine. Individuals who received text message reminders were more likely to receive dose 2 and 3 on time, with one study showing an earlier time to completion of subsequent doses. In contrast, phone call reminders did not affect timely receipt of the subsequent doses.

The content of text message should include the following 4 items, according to the researchers:

  1. Dose due date
  2. Office name
  3. Office phone number to schedule an appointment
  4. Link to the HPV Vaccine Information Statement (VIS)

The study is limited by the potential lack of generalizability of the findings to different practice settings, geographic locations, and patient demographics, the authors noted. Also, most of the studies evaluated were published over 5 years ago. Also, it is unclear from the findings whether the timing and frequency of messaging affected appointment scheduling and vaccination rates.

Using text message reminder systems increased HPV vaccination rates. “There is sufficient evidence supporting and illustrating an increase in HPV vaccination initiation or series completion because of the text message reminder system in place,” study authors concluded.


Khuwaja SS, Peck JL. Increasing HPV vaccination rates using text reminders: an integrative review of the literature. J Pediatr Health Care. 2022;S0891-5245(22)00027-X. doi: 10.1016/j.pedhc.2022.02.001