Evidence map›Paper›PMID 41536962›Full record

ArticleEuropean heart journal open2026

Electronic nudges to increase influenza vaccination uptake in younger and middle-aged individuals with atrial fibrillation: a prespecified analysis of the NUDGE-FLU-CHRONIC trial.

Caroline Espersen, Niklas Dyrby Johansen, Muthiah Vaduganathan, Ankeet S Bhatt, Daniel Modin, Kristoffer Grundtvig Skaarup, Safia Chatur, Brian L Claggett, Kira Hyldekær Janstrup, Carsten Schade Larsen and 13 more

Abstract read
In one paragraph

Article in European heart journal open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Does influenza vaccination protect people with breakthrough infections from acute cardiovascular events?Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Caroline EspersenDepartment of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte Hospitalsvej 8, 2900 Hellerup, Denmark.ORCID https://orcid.org/0000-0003-2879-8862
Niklas Dyrby JohansenDepartment of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte Hospitalsvej 8, 2900 Hellerup, Denmark.
Muthiah VaduganathanCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.ORCID https://orcid.org/0000-0003-0885-1953
Ankeet S BhattCenter for Cardiometabolic Implementation Science, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Daniel ModinDepartment of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte Hospitalsvej 8, 2900 Hellerup, Denmark.
Kristoffer Grundtvig SkaarupDepartment of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte Hospitalsvej 8, 2900 Hellerup, Denmark.
Safia ChaturCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Brian L ClaggettCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.ORCID https://orcid.org/0000-0002-4215-9218
Kira Hyldekær JanstrupDepartment of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte Hospitalsvej 8, 2900 Hellerup, Denmark.ORCID https://orcid.org/0000-0002-0391-5981
Carsten Schade LarsenDepartment of Clinical Medicine - Department of Infectious Diseases, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark.
Lykke LarsenDepartment of Infectious Diseases, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense, Denmark.ORCID https://orcid.org/0000-0002-4113-4182
Lothar WieseDepartment of Infectious Diseases, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark.ORCID https://orcid.org/0000-0003-2719-1743
Michael Dalager-PedersenDepartment of Infectious Diseases, Aalborg University Hospital, Mølleparkvej 4, 9000 Aalborg, Denmark.
Lars KøberDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.ORCID https://orcid.org/0000-0002-6635-1466
Scott D SolomonCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Pradeesh SivapalanDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.ORCID https://orcid.org/0000-0002-8620-3655
Jens Ulrik Stæhr JensenDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.ORCID https://orcid.org/0000-0003-4036-0521
Cyril Jean-Marie MartelEpidemiological Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen, Denmark.
Tyra Grove KrauseEpidemiological Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen, Denmark.
Jim HansenDepartment of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte Hospitalsvej 8, 2900 Hellerup, Denmark.ORCID https://orcid.org/0000-0001-6600-9006
Arne JohannessenDepartment of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte Hospitalsvej 8, 2900 Hellerup, Denmark.ORCID https://orcid.org/0000-0003-0294-3750
Gregory M MarcusDepartment of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
Tor Biering-SørensenDepartment of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte Hospitalsvej 8, 2900 Hellerup, Denmark.ORCID https://orcid.org/0000-0003-4209-2778

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Little is known regarding strategies to improve influenza vaccination uptake among individuals with atrial fibrillation (AF). We assessed the effect of electronically delivered behavioural nudges on influenza vaccination uptake and clinical outcomes according to AF status. Methods and results: This is a prespecified analysis of the nationwide randomized NUDGE-FLU-CHRONIC trial in which citizens aged 18-64 years with a chronic disease were randomized to usual care or six different electronic nudge letters aiming to increase influenza vaccination uptake during the 2023-2024 influenza season. The primary endpoint was receipt of an influenza vaccine on or before 1 January 2024. We reported absolute differences and relative risks (RRs) of each intervention letter vs. usual care on influenza vaccination uptake and assessed effect modification by AF status using binomial regression. Among 299 881 randomized participants, 19 481 (6.5%) had a history of AF (median age 58.5 years, 27.8% female). During follow-up, 41.5% of participants with a history of AF received influenza vaccination compared with 35.8% of those without ( Conclusion: In this prespecified, secondary analysis, electronic nudge letters highlighting the importance of influenza vaccination were especially effective in increasing influenza vaccination uptake among young and middle-aged adults with AF, supporting simple electronic letters as an efficient public health strategy to improve vaccination coverage in high-risk groups.

Indexed as

Atrial fibrillationInfluenza vaccinationNudgingRandomized trial

Identifiers

PMID41536962
PMCPMC12798726

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.