A survey of physician-led influenza immunization programs in schools

HF Hull & Associates, LLC, Saint Paul, MN 55116, USA.
Clinical Pediatrics (Impact Factor: 1.15). 05/2010; 49(5):439-42. DOI: 10.1177/0009922809346573
Source: PubMed


To determine whether school-located immunization programs (SIPs) offer an efficient method of immunizing children aged 5 to 18 years now recommended for annual influenza immunization, the author interviewed 8 of 10 physicians (identified through media reports and personal communication) who independently conducted SIPs during 2005-2007. SIPs targeted 1 to 6 schools (mainly smaller private schools) and immunized <or=33% of eligible students. Permission and payment were obtained in advance. All SIPs offered live attenuated influenza vaccines. The physicians organized the SIPs and secured the commitment of school nurses and administrators. With 1 exception, physicians were able to recoup all costs associated with the SIP. All physicians found their experience personally rewarding and expressed a willingness to organize future SIPs. Physician-led SIPs are a viable means for immunizing schoolchildren against influenza and, if properly planned, can become self-sustaining annual events, particularly in private schools.

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    ABSTRACT: In the United States, all children 6 months through 18 years of age are recommended to be vaccinated against influenza annually. However, the existing pediatric immunization infrastructure does not have the capacity to vaccinate a high proportion of children each year. School-located influenza vaccination (SLIV) programs provide an opportunity to immunize large numbers of school-age children. We reviewed the medical literature in order to document the current U.S. experience to benefit future SLIV programs. Published reports or abstracts for 36 SLIV programs were identified, some of which spanned multiple years. The programs immunized between 70-128,228 students. While most programs vaccinated 40-50% of students, coverage ranged from 7-73%. Higher percentages of elementary students were vaccinated compared with middle and high school students. While many programs offered only intranasal vaccine, several programs have successfully used both the intranasal and injectable vaccines. Faculty and staff were immunized in some programs and uptake in this group varied considerably. Students were vaccinated quickly during school hours. Costs, where reported, ranged from approximately $20-$27 per dose delivered, including both vaccine and administration costs. The greatest need for future U.S. SLIV program implementation is the development of a financially sustainable model that can be replicated annually on a national scale.
    Human vaccines 02/2011; 7(2):153-60. DOI:10.4161/hv.7.2.13668 · 3.64 Impact Factor
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    ABSTRACT: In the United States, school-located influenza vaccination (SLIV) programs have increased significantly in recent years. In June 2010, the Office of Inspector General issued a report regarding 38 elementary school H1N1 SLIV programs conducted in 6 localities in November/December 2009. By locality, there was a mean of 14 to 46 first doses of vaccine administered per 100 students. The locality that conducted programs in early November had a higher uptake rate than localities with later programs (46 vs 21 per 100 students; p < 0.01). Among localities with programs in mid- to late-November, the locality with programs after school hours had a lower uptake rate than the two localities with programs during school hours (16 vs. 28, p = 0.05 and 16 vs. 30, p < 0.01, respectively). These data suggest that future SLIV programs may achieve higher uptake rates if conducted during school hours with advance parental consent and when parental demand is highest.
    Human vaccines 08/2011; 7(8):864-7. DOI:10.4161/hv.7.8.16281 · 3.64 Impact Factor
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    ABSTRACT: School nurses played a key role in Maine's school-located influenza vaccination (SLV) clinics during the 2009-2010 pandemic season. The objective of this study was to determine, from the school district perspective, the labor hours and costs associated with outside-clinic coordination activities (OCA). The authors defined OCA as labor hours spent by staff outside of clinic operations. The authors surveyed a convenience sample of 10 school nurses from nine school districts. Eight nurses responded to the survey, representing seven districts, 45 schools and 84 SLV clinics that provided a total of 22,596 vaccine doses (H1N1 and seasonal combined) to children and adolescents. The mean total OCA time per clinic was 69 hours: out of total hours, 22 (36%) were spent outside regular clinic operation time. The authors estimated the mean cost of OCA to be $15.36 per dose. Survey respondents reported that costs would be lower during non-pandemic seasons and as schools become more proficient at planning clinics.
    The Journal of School Nursing 06/2012; 28(5):328-35. DOI:10.1177/1059840512448676 · 1.11 Impact Factor
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