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Dyda A, King C, Dey A, Leask J, Dunn AG. A systematic review of studies that measure parental vaccine attitudes and beliefs in childhood vaccination. BMC Public Health 2020; 20:1253. [PMID: 32807124 PMCID: PMC7433363 DOI: 10.1186/s12889-020-09327-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/02/2020] [Indexed: 12/13/2022] Open
Abstract
Background Acceptance of vaccines is an important predictor of vaccine uptake. This has public health implications as those who are not vaccinated are at a higher risk of infection from vaccine preventable diseases. We aimed to examine how parental attitudes and beliefs towards childhood vaccination were measured in questionnaires through a systematic review of the literature. Methods We systematically reviewed the literature to identify primary research studies using tools to measure vaccine attitudes and beliefs, published between January 2012 and May 2018. Studies were included if they involved a quantitative survey of the attitudes and beliefs of parents about vaccinations recommended for children. We undertook a synthesis of the results with a focus on evaluating the tools used to measure hesitancy. Results A total of 116 studies met the inclusion criteria, 99 used a cross sectional study design, 5 used a case control study design, 4 used a pre-post study design and 8 used mixed methods study designs. Sample sizes of included studies ranged from 49 to 12,259. The most commonly used tool was the Parent Attitudes about Childhood Vaccines (PACV) Survey (n = 7). The most common theoretical framework used was the Health Belief Model (n = 25). Questions eliciting vaccination attitudes and beliefs varied widely. Conclusions There was heterogeneity in the types of questionnaires used in studies investigating attitudes and beliefs about vaccination in parents. Methods to measure parental attitudes and beliefs about vaccination could be improved with validated and standardised yet flexible instruments. The use of a standard set of questions should be encouraged in this area of study.
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Affiliation(s)
- Amalie Dyda
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia. .,Department of Health Systems and Populations, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
| | - Catherine King
- National Centre for Immunisation Research & Surveillance, Sydney, NSW, Australia.,The University of Sydney, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - Aditi Dey
- National Centre for Immunisation Research & Surveillance, Sydney, NSW, Australia.,The University of Sydney, School of Medicine, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - Julie Leask
- National Centre for Immunisation Research & Surveillance, Sydney, NSW, Australia.,The University of Sydney, Susan Wakil School of Nursing and Midwifery, Sydney, NSW, Australia
| | - Adam G Dunn
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.,The University of Sydney, Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, Sydney, NSW, Australia
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2
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Weinberg GA. Nontraditional Uses of Live Attenuated Influenza Vaccine: School-Located Influenza Vaccination. J Pediatric Infect Dis Soc 2020; 9:S19-S23. [PMID: 32191311 DOI: 10.1093/jpids/piaa007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Immunization against influenza continues to be the best method of preventing influenza infection in children, and additionally, indirectly helping to lower disease in adults, given the role of children as "spreaders" of influenza to the community at large. An increasing evidence base exists for the use of school-located influenza vaccination (SLIV) programs to increase the influenza vaccination rates among children. Live, attenuated influenza vaccine (LAIV) has unique characteristics that make it useful for SLIV programs, including ease of immunization without needles, faster delivery, and in many (but not all) years, good vaccine effectiveness. Reviewed herein are results of selected published trials as well as guidance on planning a successful SLIV program.
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Affiliation(s)
- Geoffrey A Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, University of Rochester Golisano Children's Hospital, Rochester, New York, USA
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3
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Szilagyi PG, Schaffer S, Rand CM, Goldstein NP, Hightower AD, Younge M, Albertin CS, DiBitetto K, Yoo BK, Humiston SG. School-Located Influenza Vaccination: Do Vaccine Clinics at School Raise Vaccination Rates? THE JOURNAL OF SCHOOL HEALTH 2019; 89:1004-1012. [PMID: 31612491 DOI: 10.1111/josh.12840] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Only half of US schoolchildren receive influenza vaccine. School-located influenza vaccination (SLIV) might raise vaccination rates but conducting flu vaccine clinics at schools is challenging to implement. We compared 2 school-based programs designed to raise influenza vaccination rates: parent reminder/educational messages sent to parents from schools which is a low-intensity intervention vs the combination of reminder/educational messages plus SLIV clinics which is a high-intensity intervention. METHODS We assigned 36 schools (6 school districts, 2 per group) to 3 groups: (1) control, ie, no SLIV and no parent reminder/education, (2) parent reminder/education emailed by schools, and (3) parent reminder/education plus SLIV clinics. Some schools had SLIV clinics in prior years. Health department nurses conducted SLIV clinics. RESULTS Among 24,832 children at 36 schools, vaccination rates were control (51.3%), parent reminder/education-only (41.2%), and reminder/education + SLIV (58.7%). On multivariate analyses which controlled for vaccination in prior seasons, children in reminder/education + SLIV schools had higher vaccination rates (OR 1.27, 95% CI 1.10-1.47), but children in reminder/education-only schools had lower rates (OR 0.87, 95% CI 0.75-1.00) than children in control schools. CONCLUSIONS Parent reminder/education combined with SLIV clinics raise vaccination rates, but parent reminder/education alone does not.
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Affiliation(s)
- Peter G Szilagyi
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California Los Angeles (UCLA), Los Angeles, CA, 10833
| | - Stanley Schaffer
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642
| | - Cynthia M Rand
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642
| | - Nicolas Pn Goldstein
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642
| | - A Dirk Hightower
- Department of Clinical and Social Psychology, University of Rochester and Children's Institute, Rochester, NY, 14642
| | - Mary Younge
- Department of Public Health, Monroe County, NY, 14620
| | - Christina S Albertin
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California Los Angeles (UCLA), Los Angeles, CA, 14642
| | - Kristine DiBitetto
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642
| | - Byung-Kwang Yoo
- Department of Public Health Sciences, University of California at Davis, Davis, CA, 95616
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Szilagyi PG, Schaffer S, Rand CM, Goldstein NP, Hightower AD, Younge M, Eagan A, Blumkin A, Albertin CS, DiBitetto K, Concannon C, Vincelli P, Yoo BK, Humiston SG. Impact of elementary school-located influenza vaccinations: A stepped wedge trial across a community. Vaccine 2018; 36:2861-2869. [DOI: 10.1016/j.vaccine.2018.03.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 11/29/2022]
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Szilagyi PG, Schaffer S, Rand CM, Goldstein NPN, Vincelli P, Hightower AD, Younge M, Eagan A, Blumkin A, Albertin CS, DiBitetto K, Yoo BK, Humiston SG. School-located Influenza Vaccinations for Adolescents: A Randomized Controlled Trial. J Adolesc Health 2018; 62:157-163. [PMID: 29248390 DOI: 10.1016/j.jadohealth.2017.09.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/09/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE We aimed to evaluate the effect of school-located influenza vaccination (SLIV) on adolescents' influenza vaccination rates. METHODS In 2015-2016, we performed a cluster-randomized trial of adolescent SLIV in middle/high schools. We selected 10 pairs of schools (identical grades within pairs) and randomly allocated schools within pairs to SLIV or usual care control. At eight suburban SLIV schools, we sent parents e-mail notifications about upcoming SLIV clinics and promoted online immunization consent. At two urban SLIV schools, we sent parents (via student backpack fliers) paper immunization consent forms and information about SLIV. E-mails were unavailable at these schools. Local health department nurses administered nasal or injectable influenza vaccine at dedicated SLIV clinics and billed insurers. We compared influenza vaccination rates at SLIV versus control schools using school directories to identify the student sample in each school. We used the state immunization registry to determine receipt of influenza vaccination. RESULTS The final sample comprised 17,650 students enrolled in the 20 schools. Adolescents at suburban SLIV schools had higher overall influenza vaccination rates than did adolescents at control schools (51% vs. 46%, p < .001; adjusted odds ratio = 1.27, 95% confidence interval 1.18-1.38, controlling for vaccination during the prior two seasons). No effect of SLIV was noted among urbanschools on multivariate analysis. SLIV did not substitute for vaccinations in primary care or other settings; in suburban settings, SLIV was associated with increased vaccinations in primary care or other settings (adjusted odds ratio = 1.10, 95% confidence interval 1.02-1.19). CONCLUSIONS SLIV in this community increased influenza vaccination rates among adolescents attending suburban schools.
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Affiliation(s)
- Peter G Szilagyi
- Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles (UCLA), Los Angeles, California.
| | - Stanley Schaffer
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Cynthia M Rand
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Nicolas P N Goldstein
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Phyllis Vincelli
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - A Dirk Hightower
- Department of Clinical and Social Psychology, University of Rochester Children's Institute, Rochester, New York
| | - Mary Younge
- Department of Public Health, Monroe County, Rochester, New York
| | - Ashley Eagan
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Aaron Blumkin
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Christina S Albertin
- Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles (UCLA), Los Angeles, California
| | - Kristine DiBitetto
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Byung-Kwang Yoo
- Department of Public Health Sciences, University of California at Davis, Davis, California
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Facilitators and barriers of parental attitudes and beliefs toward school-located influenza vaccination in the United States: Systematic review. Vaccine 2017; 35:1987-1995. [PMID: 28320592 DOI: 10.1016/j.vaccine.2017.03.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/01/2017] [Accepted: 03/07/2017] [Indexed: 11/21/2022]
Abstract
The study objective was to identify facilitators and barriers of parental attitudes and beliefs toward school-located influenza vaccination in the United States. In 2009, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention expanded their recommendations for influenza vaccination to include school-aged children. We conducted a systematic review of studies focused on facilitators and barriers of parental attitudes toward school-located influenza vaccination in the United States from 1990 to 2016. We reviewed 11 articles by use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. Facilitators were free/low cost vaccination; having belief in vaccine efficacy, influenza severity, and susceptibility; belief that vaccination is beneficial, important, and a social norm; perception of school setting advantages; trust; and parental presence. Barriers were cost; concerns regarding vaccine safety, efficacy, equipment sterility, and adverse effects; perception of school setting barriers; negative physician advice of contraindications; distrust in vaccines and school-located vaccination programs; and health information privacy concerns. We identified the facilitators and barriers of parental attitudes and beliefs toward school-located influenza vaccination to assist in the evidence-based design and implementation of influenza vaccination programs targeted for children in the United States and to improve influenza vaccination coverage for population-wide health benefits.
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Szilagyi PG, Schaffer S, Rand CM, Vincelli P, Eagan A, Goldstein NPN, Hightower AD, Younge M, Blumkin A, Albertin CS, Yoo BK, Humiston SG. School-Located Influenza Vaccinations: A Randomized Trial. Pediatrics 2016; 138:peds.2016-1746. [PMID: 27940785 DOI: 10.1542/peds.2016-1746] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Assess impact of offering school-located influenza vaccination (SLIV) clinics using both Web-based and paper consent upon overall influenza vaccination rates among elementary school children. METHODS We conducted a cluster-randomized trial (stratified by suburban/urban districts) in upstate New York in 2014-2015. We randomized 44 elementary schools, selected similar pairs of schools within districts, and allocated schools to SLIV versus usual care (control). Parents of children at SLIV schools were sent information and vaccination consent forms via e-mail, backpack fliers, or both (depending on school preferences) regarding school vaccine clinics. Health department nurses conducted vaccine clinics and billed insurers. For all children registered at SLIV/control schools, we compared receipt of influenza vaccination anywhere (primary outcome). RESULTS The 44 schools served 19 776 eligible children in 2014-2015. Children in SLIV schools had higher influenza vaccination rates than children in control schools county-wide (54.1% vs 47.4%, P < .001) and in suburban (61.9% vs 53.6%, P < .001) and urban schools (43.9% vs 39.2%; P < .001). Multivariate analyses (controlling for age, grade, vaccination in previous season) confirmed bivariate findings. Among parents who consented for SLIV, nearly half of those notified by backpack fliers and four-fifths of those notified by e-mail consented online. In suburban districts, SLIV did not substitute for primary care influenza vaccination. In urban schools, some substitution occurred. CONCLUSIONS SLIV raised seasonal influenza vaccination rates county-wide and in both suburban and urban settings. SLIV did not substitute for primary care vaccinations in suburban settings where pediatricians often preorder influenza vaccine but did substitute somewhat in urban settings.
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Affiliation(s)
- Peter G Szilagyi
- Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, California;
| | - Stanley Schaffer
- Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and
| | - Cynthia M Rand
- Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and
| | - Phyllis Vincelli
- Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and
| | - Ashley Eagan
- Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and
| | - Nicolas P N Goldstein
- Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and
| | - A Dirk Hightower
- Department of Clinical and Social Psychology, Children's Institute Rochester, University of Rochester, Rochester, New York
| | - Mary Younge
- Department of Public Health, Monroe County, New York
| | - Aaron Blumkin
- Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and
| | - Christina S Albertin
- Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, California
| | - Byung-Kwang Yoo
- Department of Public Health Sciences, University of California at Davis, Davis, California; and
| | - Sharon G Humiston
- Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri
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Albright K, Barnard J, O'Leary S, Federico S, Saville A, Lockhart S, Lee M, Eblovi D, Dickinson M, Kile D, Kempe A. School-Based Health Centers as Medical Homes: Parents' and Adolescents' Perspectives. Acad Pediatr 2016; 16:381-6. [PMID: 26329018 DOI: 10.1016/j.acap.2015.06.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 06/01/2015] [Accepted: 06/01/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Preventive health services are underutilized by US adolescents, especially those from low-income populations. School-based health centers (SBHCs) have been endorsed as primary medical homes for adolescents. This study was undertaken to determine how adolescent SBHC users and their parents perceive SBHCs, particularly whether SBHCs fulfill each of the elements of a medical home as defined by the American Academy of Pediatrics. METHODS Middle and high school adolescents who had been enrolled in a SBHC in a major metropolitan school district for a minimum of 1 year were interviewed about their perceptions of and experiences with SBHCs. English- and Spanish-speaking parents of SBHC-enrolled adolescents also participated in focus groups on this topic. RESULTS Four focus groups with parents (n = 30) and 62 interviews with adolescents were completed. Both adolescents and parents indicated satisfaction with the quality and utilization of SBHC services, reporting that SBHCs were highly accessible and family centered. Many students preferred to access care at their SBHC instead of their primary care practice because of the convenience, perceived trustworthiness, compassion, and high quality of care at the SBHC. A few parents reported unmet medical needs from their adolescent's SBHC, and some differences emerged between English- and Spanish-speaking parents. CONCLUSIONS Adolescents' and parents' perceptions of care received at these SBHCs are consistent with features of the medical home model. These findings suggest that SBHCs can provide coordinated, compassionate care to students in a large, urban school system and may be perceived as more accessible than traditional primary care settings.
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Affiliation(s)
- Karen Albright
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Department of Community & Behavioral Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
| | - Juliana Barnard
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo
| | - Sean O'Leary
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colo
| | - Steve Federico
- Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Denver Health and Hospital Authority, Denver, Colo
| | - Alison Saville
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo
| | - Steven Lockhart
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo
| | - Michelle Lee
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo
| | - Darren Eblovi
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo
| | - Miriam Dickinson
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Department of Family Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colo
| | - Deidre Kile
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo
| | - Allison Kempe
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colo
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Tran CH, Brew J, Johnson N, Ryan KA, Martin B, Cornett C, Caron B, Duncan RP, Small PA, Myers PD, Morris JG. Sustainability of school-located influenza vaccination programs in Florida. Vaccine 2016; 34:2737-44. [PMID: 27126875 DOI: 10.1016/j.vaccine.2016.04.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 04/06/2016] [Accepted: 04/07/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND School-located influenza vaccination (SLIV) programs are a promising strategy for increasing vaccination coverage among schoolchildren. However, questions of economic sustainability have dampened enthusiasm for this approach in the United States. We evaluated SLIV sustainability of a health department led, county-wide SLIV program in Alachua County, Florida. Based on Alachua's outcome data, we modeled the sustainability of SLIV programs statewide using two different implementation costs and at different vaccination rates, reimbursement amount, and Vaccines for Children (VFC) coverage. METHODS Mass vaccination clinics were conducted at 69 Alachua County schools in 2013 using VFC (for Medicaid and uninsured children) and non-VFC vaccines. Claims were processed after each clinic and submitted to insurance providers for reimbursement ($5 Medicaid and $47.04 from private insurers). We collected programmatic expenditures and volunteer hours to calculate fixed and variable costs for two different implementation costs (with or without in-kind costs included). We project program sustainability for Florida using publicly available county-specific student populations and health insurance enrollment data. RESULTS Approximately 42% (n=12,853) of pre-kindergarten - 12th grade students participated in the SLIV program in Alachua. Of the 13,815 doses provided, 58% (8042) were non-VFC vaccine. Total implementation cost was $14.95/dose or $7.93/dose if "in-kind" costs were not included. The program generated a net surplus of $24,221, despite losing $4.68 on every VFC dose provided to Medicaid and uninsured children. With volunteers, 99% of Florida counties would be sustainable at a 50% vaccination rate and average reimbursement amount of $3.25 VFC and $37 non-VFC. Without volunteers, 69% of counties would be sustainable at 50% vaccination rate if all VFC recipients were on Medicaid and its reimbursement increased from $5 to $10 (amount private practices receive). CONCLUSIONS AND RELEVANCE Key factors that contributed to the sustainability and success of an SLIV program are: targeting privately insured children and reducing administration cost through volunteers. Counties with a high proportion of VFC eligible children may not be sustainable without subsidies at $5 Medicaid reimbursement.
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Affiliation(s)
- Cuc H Tran
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States; Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Joe Brew
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States; Florida Department of Health in Alachua County, Gainesville, FL, United States
| | - Nicholas Johnson
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States; Florida Department of Health in Alachua County, Gainesville, FL, United States
| | - Kathleen A Ryan
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States; Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States; College of Medicine, University of Florida, Gainesville, FL, United States
| | - Brittany Martin
- Florida Department of Health in Alachua County, Gainesville, FL, United States
| | - Catherine Cornett
- Florida Department of Health in Alachua County, Gainesville, FL, United States
| | - Brad Caron
- Florida Department of Health in Alachua County, Gainesville, FL, United States
| | - R Paul Duncan
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Parker A Small
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States; Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States; College of Medicine, University of Florida, Gainesville, FL, United States
| | - Paul D Myers
- Florida Department of Health in Alachua County, Gainesville, FL, United States
| | - J Glenn Morris
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States; Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States; College of Medicine, University of Florida, Gainesville, FL, United States.
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Weinberg GA. A Celebration of the Life and Work of Caroline Breese Hall, MD. J Pediatric Infect Dis Soc 2016; 5:e1-4. [PMID: 26908498 PMCID: PMC7107472 DOI: 10.1093/jpids/piu118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 11/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Geoffrey A. Weinberg
- University of Rochester School of Medicine and Dentistry, New York,Corresponding Author:
Geoffrey A. Weinberg, MD, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642. E-mail:
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Jacobson RM, Agunwamba AA, St Sauver JL, Finney Rutten LJ. The most effective and promising population health strategies to advance human papillomavirus vaccination. Expert Rev Vaccines 2015; 15:257-69. [PMID: 26559567 DOI: 10.1586/14760584.2016.1116947] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The US is failing to make substantive progress toward improving rates of human papillomavirus vaccine uptake. While the Healthy People 2020 goal for human papillomavirus (HPV) vaccination is 80%, the three-dose completion rate in the US in 2014 for 13- to 17-year-old females is less than 40%, and the rate for males is just above 20%. Experts point to a number of reasons for the poor HPV vaccination rates including parental concerns about safety, necessity, and timing. However, the evidence refuting these concerns is substantial. Efforts focusing on education and communication have not shown promise, but several population health strategies have reminder/recall systems; practice-focused strategies targeting staff, clinicians, and parents; assessment and feedback activities; and school-based HPV vaccination programs.
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Affiliation(s)
- Robert M Jacobson
- a Department of Pediatric and Adolescent Medicine, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery , Mayo Clinic , Rochester , MN , USA
| | - Amenah A Agunwamba
- b Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery , Mayo Clinic , Rochester , MN , USA
| | - Jennifer L St Sauver
- b Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery , Mayo Clinic , Rochester , MN , USA
| | - Lila J Finney Rutten
- b Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery , Mayo Clinic , Rochester , MN , USA
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Won TL, Middleman AB, Auslander BA, Short MB. Trust and a school-located immunization program. J Adolesc Health 2015; 56:S33-9. [PMID: 25863553 DOI: 10.1016/j.jadohealth.2014.09.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 09/29/2014] [Accepted: 09/29/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine variables associated with parental trust in a school-located immunization program (SLIP) and the effect of trust-building interventions on trust and participation in SLIPs. METHODS Parents among eight schools randomized to a trust-building intervention or a control condition (four schools each) completed a five-item trust survey before SLIP implementation both in year 1 (fall 2012) and in year 2 (fall 2013). Mean trust scores were calculated. Associations between baseline demographic and experiential variables and mean trust scores were analyzed. Mean trust scores in intervention and control schools were compared before SLIP in years 1 and 2, and SLIP participation rates were noted. RESULTS From year 1, 1,608 parent surveys were analyzed. Baseline mean trust score across schools was 3.59 of 5 (5 = highest trust). In a multiple linear regression model, annual household income, survey language version, participation in a previous SLIP, child's health insurance status, and perceived vaccine importance were significantly associated with parental trust in SLIPs (R(2)= .06, p < .001). There was no difference in mean trust scores between intervention and control schools (p = .8). In year 2, 844 surveys were analyzed, and a modest difference was observed between intervention and control schools (mean trust score = 3.66 and 3.57, respectively, p = .07). SLIP participation rates appeared higher in intervention (7.7%) versus control schools (4.3%) in year 1. CONCLUSIONS Baseline trust in SLIPs among a low-income, largely Hispanic group of parents in Texas was moderately high. Factors associated with trust included demographic and experiential variables, and interventions aimed at increasing parents' perception of vaccine importance and participation in SLIPs may be effective in increasing parental trust in SLIPs.
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Affiliation(s)
| | - Amy B Middleman
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
| | - Beth A Auslander
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
| | - Mary B Short
- Department of Psychology, University of Houston-Clear Lake, Clear Lake, Texas
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13
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Humiston SG, Poehling KA, Szilagyi PG. School-located influenza vaccination: can collaborative efforts go the distance? Acad Pediatr 2014; 14:219-20. [PMID: 24767773 DOI: 10.1016/j.acap.2014.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 03/10/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Sharon G Humiston
- Department of Pediatrics, Children's Mercy Hospital and Clinics, Kansas City, MO.
| | | | - Peter G Szilagyi
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY
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