Promising Practices for School-located Vaccination Clinics--: Part II: Clinic Operations and Program Sustainability
Knox County Health Department, 140 Dameron Ave., Knoxville, TN 37917, USA. PEDIATRICS
(Impact Factor: 5.47).
03/2012; 129 Suppl 2(Supplement):S81-7. DOI: 10.1542/peds.2011-0737G
A school-located mass vaccination program can enable rapid vaccination of a large number of students while minimizing disruption of their school activities. During 3 consecutive influenza seasons beginning in 2005, the Knox County Health Department conducted school-located mass vaccination clinics using live attenuated influenza vaccine. Overall, the proportion of elementary schoolchildren vaccinated with live attenuated influenza vaccine exceeded 40% each year. We describe key lessons learned in clinic operations, including obtaining informed consent, defining the organizational structure and roles, preparing the school, staffing, training, supplies, vaccine management, team communication, and data management. We conclude by discussing program costs and sustainability.
Available from: pediatrics.aappublications.org
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ABSTRACT: A school-located mass vaccination clinic approach can enable rapid vaccination of a large number of students while minimizing disruption of their school activities and potentially reducing missed work hours by parents. During 3 consecutive influenza seasons beginning in 2005, the Knox County Health Department conducted school-located mass vaccination clinics using live attenuated influenza vaccine. Clinics were held each year throughout the county over 4 weeks in more than 100 public and private schools for more than 65, 000 students in Grades K to 12. Overall, the proportion of all students vaccinated at school each year exceeded 40%. Our experience indicated that careful and thorough planning was essential to program success. Critical planning elements included (1) initial planning with extensive lead time to find the proper lead agency and project leader and to develop sound comprehensive vaccine clinic planning; (2) developing partnerships, especially with schools; (3) communicating successfully with parents, children, school administrators and teachers, medical providers, and the community at large; and (4) educating these groups successfully, using good timing, through local media, school events, direct mailings (including parents receiving information and consent packets), and partners. We review here the details of these key planning elements.
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ABSTRACT: Influenza vaccination coverage for U.S. school-aged children is below the 80% national goal. Primary care practices may not have the capacity to vaccinate all children during influenza vaccination season. No real-world models of school-located seasonal influenza (SLV-I) programs have been tested.
Determine the feasibility, sustainability, and impact of an SLV-I program providing influenza vaccination to elementary school children during the school day.
In this pragmatic randomized controlled trial of SLV-I during two vaccination seasons, schools were randomly assigned to SLV-I versus standard of care. Seasonal influenza vaccine receipt, as recorded in the state immunization information system (IIS), was measured.
Intervention and control schools were located in a single western New York county. Participation (intervention or control) included the sole urban school district and suburban districts (five in Year 1, four in Year 2).
After gathering parental consent and insurance information, live attenuated and inactivated seasonal influenza vaccines were offered in elementary schools during the school day.
Data on receipt of ≥1 seasonal influenza vaccination in Year 1 (2009-2010) and Year 2 (2010-2011) were collected on all student grades K through 5 at intervention and control schools from the IIS in the Spring of 2010 and 2011, respectively. Additionally, coverage achieved through SLV-I was compared to coverage of children vaccinated elsewhere. Preliminary data analysis for Year 1 occurred in Spring 2010; final quantitative analysis for both years was completed in late Fall 2012.
Results are shown for 2009-2010 and 2010-2011, respectively: Children enrolled in suburban SLV-I versus control schools had vaccination coverage of 47% vs 36%, and 52% vs 36% (p<0.0001 both years). In urban areas, coverage was 36% vs 26%, and 31% vs 25% (p<0.001 both years). On multilevel logistic analysis with three nested levels (student, school, school district) during both vaccination seasons, children were more likely to be vaccinated in SLV-I versus control schools; ORs were 1.6 (95% CI=1.4, 1.9; p<0.001) and 1.5 (95% CI=1.3, 1.8; p<0.001).
Delivering influenza vaccine during school is a promising approach to improving pediatric influenza vaccination coverage.
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