Why does flu vaccination still fall short each year?
Every year, seasonal influenza contributes to millions of illnesses, hundreds of thousands of hospitalizations, and substantial health care costs in the United States. Yet despite longstanding public health recommendations and broad vaccine availability, many eligible individuals still do not receive an annual flu vaccine.
Improving vaccination rates remains an important opportunity for employers, health plans and health care organizations seeking to advance population health and help individuals avoid preventable illness. However, encouraging participation in preventive care programs can be challenging. Traditional outreach methods such as mail, email and live-agent phone calls can be effective, but reaching large populations during a relatively short flu vaccination season often requires significant resources.
As organizations look for new ways to engage people in preventive care, an important question emerges: can more personalized outreach help motivate action?
What can we learn from a flu outreach pilot?
During the 2025-2026 flu season, The Cigna Group piloted an outreach program designed to encourage flu vaccination among targeted customer populations. The initiative sought to better understand whether personalized engagement could help increase participation in preventive care activities.
The program reached more than 83,000 eligible individuals through personalized telephone outreach. Approximately 9.4% of outreach attempts resulted in a completed conversation focused on flu vaccination, preventive health and available vaccination options. Researchers then evaluated medical and pharmacy claims data from August 1, 2025 through June 1, 2026 to assess flu vaccination activity within the outreach population.
What did the research find?
The analysis identified a meaningful difference in vaccination rates among individuals who engaged in a completed outreach conversation.
Key findings included:
28% flu vaccination rate among individuals who completed the outreach conversation
Approximately 20% flu vaccination rate across the overall outreach population
17% to 19% flu vaccination rates among comparable book-of-business populations
Individuals who completed the outreach conversation experienced a flu vaccination rate approximately 43% higher than a comparable population with both medical and pharmacy coverage
The findings suggest that personalized outreach may play an important role in helping individuals take preventive health actions, particularly during time-sensitive periods such as flu season.
Researchers also examined flu-related hospitalization outcomes. Hospitalization rates among individuals receiving outreach were generally similar to those observed across broader populations. However, the small number of hospitalizations limited the ability to draw statistically meaningful conclusions regarding downstream clinical outcomes.
Why does personalized engagement matter?
Preventive care often depends on timing, awareness and convenience. Even when individuals intend to receive recommended preventive services, competing priorities, lack of information or simple forgetfulness can create barriers to action.
Personalized outreach can help address these challenges by:
Reaching individuals when preventive action is most relevant
Reinforcing the importance of recommended preventive services
Providing information tailored to an individual's needs
Helping people better understand available options and next steps
For employers and health plans, increasing participation in preventive care programs may support broader goals related to population health, member experience and long-term health outcomes.
How did technology help scale the outreach effort?
A key component of the pilot was the use of conversational AI technology to support outreach efforts at scale. Rather than serving as the focus of the program, the technology enabled personalized conversations to be delivered to a large population during a relatively short vaccination window.
This approach allowed outreach efforts to reach thousands of eligible individuals while providing information about flu vaccination and preventive care. Traditional engagement methods remain valuable, particularly when individuals need more complex clinical guidance or personalized support. However, technology-enabled outreach may provide an additional tool to help extend the reach of preventive engagement programs.
The goal is not to replace human interaction but to expand opportunities to connect more people with timely health information and preventive care resources.
What are the limitations of the findings?
These results should be interpreted in the context of the study design. The analysis identifies an association between completed outreach conversations and higher flu vaccination rates; it does not establish direct causality. Individuals who chose to engage may differ in meaningful ways from those who did not, and those differences may have influenced outcomes.
Additional research across larger populations and future flu seasons will help further evaluate the relationship between personalized outreach and preventive care participation.
Looking ahead
As organizations continue exploring ways to improve participation in preventive care, the findings from this pilot highlight the potential value of personalized engagement strategies.
While further research is needed, these early results suggest that reaching people with relevant information at the right time may help encourage preventive health actions, including flu vaccination. For employers and health plans focused on improving health outcomes, the opportunity may be less about the technology itself and more about finding effective ways to connect individuals with the preventive care services that can help keep them healthy.
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