Kaiser Permanente
COVID-19 vaccination among patients at high risk for severe disease has declined in the United States since 2022. Prior research, including discrete choice experiments (DCEs), has demonstrated that vaccine preferences are influenced by attributes such as effectiveness, safety, convenience, and protection against severe disease. Although DCEs provide valuable insights into stated vaccine preferences and decision-making, they rely on hypothetical scenarios and cannot directly assess how vaccine attributes influence real-world vaccine uptake. Additional research is needed to understand the relationship between vaccine characteristics and observed COVID-19 vaccination behavior in routine clinical practice. The EMPOWeR study is a pragmatic randomized controlled trial conducted within Kaiser Permanente Southern California (KPSC) to evaluate the effect of immunization messages and reminders that highlight COVID-19 vaccine choices on vaccine uptake. The primary research questions are: 1. Does having a choice in COVID-19 vaccine platform affect vaccine uptake among patients at high-risk of severe disease? 1a. Does having a choice in COVID-19 vaccine platform affect vaccine uptake among patients at high-risk of severe disease, when differences in vaccine platform are highlighted? 1b. Does having a choice in COVID-19 vaccine platform affect vaccine uptake among patients at high-risk of severe disease, when a trusted healthcare professional (HCP) endorses both vaccine options? 1c. Does having a choice in COVID-19 vaccine platform affect vaccine uptake among patients at high-risk of severe disease, when vaccine reactogenicity is highlighted? A secondary research question is: 2. Does having a choice in COVID-19 vaccine additionally increase uptake of influenza vaccine? During the 2026-2027 respiratory virus season, eligible KPSC members who are at high-risk of severe COVID-19 will be randomly assigned to receive a standard reminder message or a reminder message with additional information about available COVID-19 vaccine options.
The Effect of Messaging on Pragmatic Outcomes Within an Integrated Healthcare System: A Randomized Trial (EMPOWeR) study is designed to learn whether vaccine reminder messages that highlight a patient's choice of COVID-19 vaccines can help increase vaccine uptake among adults who are at higher risk for serious illness from COVID-19. The study will take place within KPSC, a large integrated health care system in southern California, and will use routine health care messages and reminders for updated COVID-19 immunization . COVID-19 vaccination rates have declined since 2022, including among ol…
Inclusion Criteria: * Aged ≥18 years; * Active KPSC member; * Continuous membership from 27 August 2025 to 27 September 2026; * Members who are aged 65 years and older, or adults aged 18-64 years with at least one of the following health conditions that increases their risk for severe COVID-19 illness, including: a) asthma, b) cancer, c) ischemic stroke, d) intracerebral or subarachnoid hemorrhage, e) transient ischemic attack, f) chronic kidney disease, g) dialysis, h) bronchiectasis, i) chronic obstructive, pulmonary disease (COPD), j) pulmonary fibrosis, k) cystic fibrosis, l) pulmonary hy…
A message communicating available choices of COVID-19 vaccines.
A message communicating available choices of COVID-19 vaccines and differences in vaccine composition and mechanisms of protection by vaccine type.
A message communicating available choices of COVID-19 vaccines and emphasizes the support of healthcare personnel (HCP) for both vaccine options.
A message communicating available choices of COVID-19 vaccines and expected side effects of available vaccines.