A Hybrid Chatbot to Promote Pneumococcal Vaccination Among Older Adults: A Randomized Clinical Trial

1. This randomized clinical trial found that a hybrid chatbot was more effective than the standard intervention at increasing pneumococcal vaccine (PV) uptake in older adults living in Hong Kong.

Evidence Rating Level: 1 (Excellent) 

People 65 years or older have an increased risk of pneumococcal disease (PD) and invasive PD (IPD); however, only 35% received the recommended pneumococcal vaccination (PV) in 2023. While previous interventions, such as phone calls and home visits, have improved vaccine uptake, these are resource-intensive and thus more difficult to implement. This study tested a more reasonable solution: a hybrid chatbot combining rule-based messaging with AI-powered Q&A, tailored to users’ readiness to get vaccinated. This randomized clinical trial compared the effectiveness of a hybrid chatbot with a standard online chatbot in increasing PV uptake among older Hong Kong residents. The primary outcome of the study was self-reported PV uptake, measured after completing the intervention. After meeting eligibility criteria, 374 individuals were included in the study, and randomly assigned to either the hybrid intervention (n=187) or the standard intervention (n=187) (mean [SD] age of both groups 69.6 [3.1] years). In the intention to treat analysis, the intervention group had a significantly higher PV uptake rate compared to the standard intervention group (29.4% vs 18.7%, relative risk, 1.57 [95% CI, 1.08-2.28]; absolute risk reduction, 0.11 [95% CI, 0.02-0.19]; and number needed to treat, 9.4 [95% CI, 5.2-47.7]; P = .01). This randomized clinical trial supported the efficacy of a hybrid chatbot compared to a standard chatbot-delivered intervention in increasing PV uptake in older individuals in Hong Kong. 

Click here to read this study in JAMA Network Open

Image: PD

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