A School-Located Vaccination Adolescent Pilot Initiative in Chicago: Lessons Learned

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 2 Issue 3 September 2013
http://jpids.oxfordjournals.org/content/current

A School-Located Vaccination Adolescent Pilot Initiative in Chicago: Lessons Learned
Rachel N. Caskey1, Everly Macario2, Daniel C. Johnson2, Tamara Hamlish2 and Kenneth A. Alexander2
Author Affiliations
1Department of Pediatrics, University of Illinois at Chicago;
2Department of Pediatrics, University of Chicago
Corresponding Author: Everly Macario, ScD, MS, EdM, Department of Pediatrics, University of Chicago, 5629 S Dorchester Ave, Chicago, IL 60637. E-mail: everly.macario@gmail.com.
Received July 25, 2012.
Accepted November 9, 2012.
http://jpids.oxfordjournals.org/content/2/3/198.abstract

Abstract
Background
Many adolescents underutilize preventive services and are underimmunized.

Methods
To promote medical homes and increase immunization rates, we conceptualized and implemented a 3-year, 8-school pilot school-located vaccination collaborative program. We sought community, parent, and school nurse input the year prior to implementation. We selected schools with predominantly Medicaid-enrolled or Medicaid-eligible students to receive Vaccines For Children stock vaccines. Nurses employed by a mass immunizer delivered these vaccines at participating schools 3 times a year.

Results
Over 3 years, we delivered approximately 1800 vaccines at schools. School administrators, health centers, and neighboring private physicians generally welcomed the program. Parents did not express overt concerns about school-located vaccination. School nurses were not able to participate because of multiple school assignments. Obtaining parental consent via backpack mail was an inefficient process, and classroom incentives did not increase consent form return rate. The influenza vaccine had the most prolific uptake. The optimal time for administering vaccines was during regular school hours.

Conclusions
Although school-located vaccination for adolescents is feasible, this is a paradigm shift for community members and thus accompanies challenges in implementation. High principal or school personnel turnover led to a consequent lack of institutional memory. It was difficult to communicate directly with parents. Because we were uncertain about the proportion of parents who received consent forms, we are exploring Internet-based and back-to-school registration options for making the consent form distribution and return process more rigorous. Securing an immunization champion at each school helped the immunization processes. Identifying a financially sustainable school-located vaccination model is critical for national expansion of school-located vaccination.