School-based influenza vaccine delivery, vaccination rates, and healthcare use in the context of a universal influenza immunization program: An ecological study

The Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Room G1 06, Toronto, Ontario M4N 3M5, Canada.
Vaccine (Impact Factor: 3.62). 03/2010; 28(15):2722-9. DOI: 10.1016/j.vaccine.2010.01.024
Source: PubMed


Influenza vaccines are universally funded in Ontario, Canada. Some public health units (PHUs) vaccinate children in schools. We examined the impact of school-based delivery on vaccination rates and healthcare use of the entire population over seven influenza seasons (2000-2007) using population-based survey and health administrative data. School-based vaccination was associated with higher vaccination rates in school-age children only. Doctors' office visits were lower for PHUs with school-based vaccination for children aged 12-19 but not for other age groups. Emergency department use and hospitalizations were similar between the two groups. In the context of universal influenza vaccination, school-based delivery is associated with higher vaccination rates and modest reductions in healthcare use in school-age children.

8 Reads
  • Source
    • "Despite this, influenza vaccination coverage remains low, especially among children and youth [29], [30]. Delivering seasonal influenza vaccination to children at school is a strategy that is not widely used within Canadian provinces and has been tried (but not sustained) in only a few local areas within the province of Ontario [31]. While the perspectives of both health and education sector stakeholders must be considered in the design of such a program, parents are key stakeholders in any vaccination program that targets children as it is they who ultimately decide both if children should be vaccinated and where they should access this health service. "
    [Show abstract] [Hide abstract]
    ABSTRACT: School-age children are important drivers of annual influenza epidemics yet influenza vaccination coverage of this population is low despite universal publicly funded influenza vaccination in Alberta, Canada. Immunizing children at school may potentially increase vaccine uptake. As parents are a key stakeholder group for such a program, it is important to consider their concerns. We explored parents' perspectives on the acceptability of adding an annual influenza immunization to the immunization program that is currently delivered in Alberta schools, and obtained suggestions for structuring such a program. Forty-eight parents of children aged 5-18 years participated in 9 focus groups. Participants lived in urban areas of the Alberta Health Services Calgary Zone. Three major themes emerged: Advantages of school-based influenza vaccination (SBIV), Disadvantages of SBIV, and Implications for program design & delivery. Advantages were perceived to occur for different populations: children (e.g. emotional support), families (e.g. convenience), the community (e.g. benefits for school and multicultural communities), the health sector (e.g. reductions in costs due to burden of illness) and to society at large (e.g. indirect conduit of information about health services, building structure for pandemic preparedness, building healthy lifestyles). Disadvantages, however, might also occur for children (e.g. older children less likely to be immunized), families (e.g. communication challenges, perceived loss of parental control over information, choices and decisions) and the education sector (loss of instructional time). Nine second-level themes emerged within the major theme of Implications for program design & delivery: program goals/objectives, consent process, stakeholder consultation, age-appropriate program, education, communication, logistics, immunizing agent, and clinic process. Parents perceived advantages and disadvantages to delivering annual seasonal influenza immunizations to children at school. Their input gives a framework of issues to address in order to construct robust, acceptable programs for delivering influenza or other vaccines in schools.
    Full-text · Article · Mar 2014 · PLoS ONE
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Ad hoc Networking Over UTRA-TDD Protocol (Barnawi and Gardiner (2003)) (ANOUP) was introduced by our research group as a protocol to combine ad hoc networking with the fixed wireless infrastructure. The aim of that combination is to improve the capacity and coverage of the cellular system. In this paper we evaluate the impact of ANOUP on the system's performance. It is shown that at a fairly good link capacity, coverage improvement of 100 % is quite achievable.
    No preview · Conference Paper · Jun 2004
  • [Show abstract] [Hide abstract]
    ABSTRACT: Seasonal influenza represents a considerable public health burden, and annual vaccination represents the most effective preventive strategy for amelioration of this problem. Certain groups are at greatest risk, such as the young, the elderly, pregnant women, and those with chronic underlying medical conditions: the high-risk groups. Traditionally, annual vaccination has been targeted to people classified as being at high risk, particularly the elderly, but in recent years, there has been a broadening of vaccination recommendations to target larger numbers of people. This has recently culminated in the recommendation of "universal vaccination" in the USA (everyone over 6 months of age is recommended to receive the seasonal influenza vaccine). In this review, we will look at coverage rates in Europe and the USA, changes in vaccination guidelines, and the rationale for broadening vaccination recommendations. It is clear that often only modest improvements in vaccination coverage have occurred recently, with programs targeting risk groups, but some substantial increases in coverage have followed the broadening of USA vaccination recommendations to all persons under 18 years and to middle-aged healthy adults (> or =50 years). It is likely, however, that some of these increases may be because of the increased awareness related to the recent pandemic. It is unclear if increases in coverage will translate into public health benefits, but perhaps results will be similar to experiments with universal vaccination in Ontario, Canada, where increased coverage may have provided some reductions in healthcare use, fewer influenza-associated deaths, and even financial benefits.
    No preview · Article · Sep 2010 · Vaccine
Show more