Vaccine
Volume 29, Issue 52 pp. 9573-9722 (6 December 2011)
http://www.sciencedirect.com/science/journal/0264410X

Reviews
School-based vaccination: A systematic review of process evaluations
Pages 9588-9599
Spring Chenoa Cooper Robbins, Kirsten Ward, S. Rachel Skinner

Abstract
Objective
School-based vaccination is becoming a more widely used method of vaccine delivery. However, evaluations of school-based vaccination program implementation have not been systematically reviewed. This paper describes the results of a systematic review of the literature on process (or implementation) evaluations of school-based vaccination delivery.

Methods
Search terms: “school based vaccination” OR ((“schools” OR “school”) AND (“immunisation” OR “immunization” OR “vaccination”)). Limits: Humans; English language; Age: 6–18 (school-age children and adolescents); No editorials; No letters. Databases: PUBMED; ; Cochrane Database of Systematic Reviews; Cinahl; Web of Science; PsycINFO. Inclusions: Articles must have originated from an advanced economic ‘developed’ country, be peer-reviewed, available in English, randomised or non-randomised controlled design, published from 1970 to August 2010 and focused on vaccinations provided in the school setting and during school time which reported one or more outcomes. Exclusions: qualitative or descriptive papers without any evaluation component; papers that only reported on impact evaluation (i.e. number of students vaccinated); and those published before 1970.

Results
A total of 14 articles were identified as including some element of a process evaluation of a school-based vaccination program. Nurses, parents, teachers, and adolescents were involved in measures of procedural factors related to school-based vaccination implementation. Outcomes included return rates of consent forms; knowledge about the specific vaccine offered; attitudes toward vaccination and school-based vaccination; reasons for non-vaccination; resources, support, and procedures related to implementation; and environmental factors within the school that may impact vaccination success. Vaccination coverage was also reported in the majority of papers.