DENVER, Colorado — A new Denver Health study published Tuesday in JAMA Network Open found that text messages and digital stories featuring Black community members increased influenza vaccination rates among children by 63%, offering a potential solution as pediatric flu vaccination rates nationwide continue to decline.

Dr. Joshua T.B. Williams, a general pediatrician at Denver Health, led the randomized clinical trial involving 200 children and 198 caregivers from two safety-net clinics in Denver’s Five Points and Northeast Park Hill neighborhoods. The study recruited caregivers with children aged 6 months to 5 years old between September 2024 and March 2025.

“We are in a severe influenza season where we are seeing a lot of hospitalizations, already seeing deaths in children and adults,” Williams said. “It’s in a timely study for the current moment.”

The research divided participating families into two groups. Half received standard Denver Health messages via an electronic health record portal, while the other half received co-created text messages and digital stories featuring lived experiences from community members, with three of five stories centering Black mothers.

Children whose caregivers received the culturally tailored intervention were 63% more likely to be vaccinated during the influenza season compared to children of caregivers receiving usual care, according to the study. 

The study found that 62% of children in the intervention group, the group that received the custom messages, remained unvaccinated compared to 74% in the usual care group.

“It’s much more likely to improve confidence like influenza vaccines, where historically there has been a lot of hesitancy,” Williams said.

The study specifically focused on Black families due to significant vaccination disparities. Colorado Department of Public Health and Environment data shows 25.2% of white children received flu vaccines this season, compared to 18.9% of Black children and 7.6% of Hispanic or Latino children.

The research comes as pediatric flu vaccination rates have fallen dramatically nationwide. According to the CDC, 50.4% of children were vaccinated during the 2020-2021 flu season. That number dropped to 41.9% for the 2024-25 season.

“Since the pandemic, we have seen decreases in national vaccination coverage among young children among three to four to five percent every single year, year over year,” Williams said.

Williams emphasized the importance of community engagement throughout the research process, noting the study succeeded because it elevated voices from within the community rather than relying solely on medical experts. The study was conducted in partnership with the Center for African American Health.

The trial also found children with one or more visits to their medical home during the season were more than five times as likely to be vaccinated as those without any visits, regardless of study group assignment.

Overall, 41% of children in the intervention group and 28% in the usual care group received one or more flu vaccines by season’s end. The research was supported by the Center for African American Health.