Immunizations from Ground Zero: Lessons Learned in Urban Middle Schools

Abstract

The Centers for Disease Control and Prevention funded a three-year demonstration project in San Francisco to assess the feasibility of a large-scale school-based vaccination effort. The project overcame a number of barriers, including lack of pre-existing health services, diversity of home languages, and an every-50-minute-bell schedule. The project targeted seventh graders and all special education students for hepatitis B vaccine (HBVac). Of 4,928 students targeted, 3,509 (71%) consented to vaccination and received the first dose. Of these 3,509 students, 3,256 (93%) completed the three-dose series at school. Key lessons learned include emphasizing a collaborative process in the planning stage, offering an educational component for students, providing an incentive to get timely parental consent, planning distribution and collection of parent materials, and planning vaccination clinics to minimize interrupting the school day. The project clearly demonstrated that, with sufficient attention to political and logistical dimensions, school-based vaccination programs are possible in large urban schools.

A Pilot Study of the Effectiveness of a School-Based Influenza Vaccination Program

“…The household survey form elicited no personal identifying information and included questions about household composition and the receipt of either FluMist or parenteral trivalent inactivated vaccine (TIV) by household members that season. Using a 7-day (December [13][14][15][16][17][18][19]2003) recall period, the survey elicited information regarding the occurrence of FRI, which was defined as a temperature of Ͼ100.4°F or cough, wheezing, pharyngitis, runny nose, nasal congestion, sinus problem, earache, ear infection, headache, or muscle aches. FRI-related medical visits (medical offices or emergency departments) by adults and children were recorded.…”

“…15,16 Also, school-based settings have been used to administer live attenuated vac-cines, including poliomyelitis, varicella, measles, and rubella, and inactivated vaccines, such as hepatitis B, diphtheria, tetanus, and pertussis. [17][18][19][20] This small pilot study was designed to assess the feasibility of a school-based influenza immunization program and to examine its impact on influenzarelated morbidity in the households of target school pupils. FluMist (influenza virus vaccine, live, intranasal; MedImmune, Gaithersburg, MD) was offered, at no cost, to healthy pupils in 1 elementary school (the target school).…”

School-based HPV immunization of young adolescents: Effects of two brief health interventions

“…4 School-based health centers (SBHCs) in the US represent an alternative to primary care settings for immunization because most children aged 14 years are in school 5 and SBHCs minimize common obstacles (e.g., parents missing work). 6,7 Thus, it is not surprising that most US parents support SBHC immunization programs 8,9 and that these programs have been shown to increase immunization rates among socially disadvantaged youth. [9][10][11][12] SBHC's procedures for administering immunizations vary according to state, health center, and immunization type, i.e, required versus mandated.…”

Adolescent Immunizations: Policies to Provide a Shot in the Arm for Adolescents

“…Approximately 4% of teens and 11% of impoverished adolescents use community clinics for routine health care [50]. School clinics have already been enlisted in several immunization programs with great success [51][52][53][54][55][56], and city clinics are often used as immunization sites for adolescents. With the advent of the HPV vaccine, it is expected that gynecology offices will also become more involved in the administration of at least some vaccines.…”