This kind of forecasting could improve preparation and management of annual flu outbreaks in the United States, said Irene Eckstrand of the National Institutes of Health.

Sending parents educational text messages about the flu vaccine and where to get it could increase the number of children and teens protected during flu season, according to a study in New York City.

Researchers, whose findings appeared in the Journal of the American Medical Association, followed more than 9,000 mostly low-income children and found that when parents got a series of text messages starting early in the flu season, their children were more likely to have received a flu shot by the end of the season than children whose parents didn't receive the texts.

Text messages may be more effective than calling a household or sending a reminder letter because texts are sent to a specific person and stored in the phone, researchers said.

“You can reach so many families and patients at one time in an automated, efficient fashion, and you tailor it to what the families need,” said Melissa Stockwell, an assistant professor of pediatrics and of population and family health at the Columbia University Mailman School of Public Health.

For the study, Sockwell's team enrolled 9,213 children and teens between six months and 18-years-old at four community-based clinics in New York before the start of flu season in 2010. Typically, the season begins in October and extends through March, but peaks in January and February.

More than half came from Spanish-speaking families and almost 90 percent were publicly insured.

Parents of about half the children and teens received weekly text messages, and all parents in the text group as well as a comparison group received a reminder phone call in November.

The researchers created a software program that combined information from the clinics' electronic health records and New York City's immunisation database to send parents five texts that were personalised based on information in the patients' medical records.

The first three texts focused on educating the parent about vaccine safety, and emphasised the seriousness of flu in children. The messages were sent in either English or Spanish.

The last two tests told parents about weekly Saturday vaccine clinics held in the fall. In January, if a child was still not vaccinated, another two text messages were sent.

At the end of the study in March 2011, about 44 percent of the children and teens in the texting group were vaccinated, compared to 40 percent of those whose parents did not receive the texts.

Stockwell's team cautioned that their results may underestimate the potential effectiveness of the texts because not every family was told about all vaccine clinic dates to prevent overcrowding. Their results are also limited to a single medical system and might not be applicable to the general public.

“The potential is substantial, and in the right setting with automated, integrated information systems, text message reminders can target large numbers of patients at relatively low cost,” wrote Peter Szilagyi and William Adams from the University of Rochester School of Medicine and Dentistry, and the Boston University School of Medicine, respectively.

The two said that if the new study's results were applied across the United States, an additional 2.5 million children and teens would be vaccinated.

Adams said that text message reminders or similar electronic interactions were likely to become more common.

“It's pretty quickly not going to be research, it's going to be everyday healthcare,” he said. - Reuters