Boosting vaccination uptake using wastewater surveillance: a county-randomized controlled trial

Researchers conducted a randomized trial in 40 counties in New York State during fall 2024, with 20 counties receiving an intervention and 20 serving as controls. The intervention consisted of a social media campaign based on alerts from community-level wastewater surveillance. The campaign achieved over 16.6 million impressions and more than 77,000 clicks on the call-to-action link. During the campaign period, intervention counties administered significantly more COVID-19 vaccine doses (76.7 doses per 100,000 residents per week) but fewer influenza vaccine doses (140.9 fewer doses per 100,000 residents per week) compared to control counties. However, season-level analysis showed no significant differences in COVID-19 or influenza vaccination uptake between groups. The findings suggest the potential of alerts from community-level wastewater surveillance in promoting vaccination.