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Yarnoff B, Wagner LD, Honeycutt AA, Vogt TM. Analysis of School-Day Disruption of Administering School-Located Vaccination to Children in Three Local Areas, 2012-2013 School Year. J Sch Nurs 2023; 39:456-462. [PMID: 34405720 DOI: 10.1177/10598405211038598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to determine the amount of time elementary and middle-school students spend away from the classroom and clinic time required to administer vaccines in school-located vaccination (SLV) clinics. We conducted a time study and estimated average time away from class and time to administer vaccine by health department (HD), student grade level, vaccine type, and vaccination process for SLV clinics during the 2012-2013 school year. Average time away from classroom was 10 min (sample: 688 students, 15 schools, three participating HD districts). Overall, time to administer intranasally administered influenza vaccine was nearly half the time to administer injected vaccine (52.5 vs. 101.7 s) (sample: 330 students, two HDs). SLV administration requires minimal time outside of class for elementary and middle-school students. SLV clinics may be an efficient way to administer catch-up vaccines to children who missed routine vaccinations during the coronavirus disease-2019 pandemic.
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Affiliation(s)
- Ben Yarnoff
- Health Economics Program, RTI International, Durham, NC, USA
| | - Laura Danielle Wagner
- Health Economics Program, RTI International, Durham, NC, USA
- Global Public Health Impact Center, RTI International, Durham, NC, USA
| | | | - Tara M Vogt
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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The Landscape of State and Local School-Located Vaccination Clinics: Practices, Policies, and Lessons Learned for Providing COVID-19 and Routine Vaccinations. NASN Sch Nurse 2022; 37:3S-14S. [PMID: 34974775 DOI: 10.1177/1942602X211064750] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For decades, school-located vaccinations clinics (SLVs) have successfully offered influenza and routine childhood immunizations that have contributed to lowering the morbidity and mortality of vaccine-preventable diseases. These SLVs laid the foundation for state and local health departments and school districts to quickly implement SLVs in response to COVID-19. To support school nurses and immunization programs in implementing future SLVs during the COVID-19 pandemic, we explored the landscape of SLVs between August 2019 and late summer 2021 using publicly available information from school and health department websites, news articles reporting on SLVs, and internal documents provided by school nurses and immunization programs who hosted SLVs. Our scan identified variability in the reach, scope, and approach to SLVs, but consistent themes persist such as the importance of partnerships and SLVs as an opportunity to promote equitable access to vaccinations. Useful documents and resources for planning and hosting SLV clinics were compiled into a table. With COVID-19 vaccines now available to all school-age children, SLVs provide an even greater opportunity to improve school and community health. The included resources are designed to provide support for those interested in SLV implementation.
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Key Challenges and Opportunities for Implementing School Located Vaccination Clinics for COVID-19 and Influenza: Roundtables With School Nurses and Immunization Programs. NASN Sch Nurse 2022; 37:15S-23S. [PMID: 34974774 DOI: 10.1177/1942602X211064752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
School-located vaccination clinics (SLVs) are an established strategy to offer influenza and routine vaccinations and improve student and community health. The COVID-19 pandemic has led many communities to expand SLVs to include COVID-19 vaccines. However, these SLVs are less documented than in the past due to the fast-paced nature of the pandemic and the additional pressures put on schools and public health organizations. We conducted five virtual roundtables with 30 school nurses and state immunization program managers from across the United States to gain insight into SLVs occurring during the COVID-19 pandemic. Roundtables explored participants' experiences planning and implementing SLVs, including factors influencing success and available resources. Findings highlighted SLVs as an opportunity to increase access and equity for vaccines. Participants shared strategies for School-located vaccination (SLV) funding, partnership building, vaccine storage and management, consent, data sharing, messaging, and promotion. These shared experiences offer useful insights for those interested in future and sustained SLV implementation.
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Kempe A, Allison MA, Daley MF. Can School-Located Vaccination Have a Major Impact on Human Papillomavirus Vaccination Rates in the United States? Acad Pediatr 2018; 18:S101-S105. [PMID: 29502627 DOI: 10.1016/j.acap.2017.08.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 08/15/2017] [Accepted: 08/19/2017] [Indexed: 10/17/2022]
Abstract
School-local vaccination (SLV) has been a highly effective method of increasing rates of human papillomavirus (HPV) vaccination in many countries internationally in which vaccines are purchased by national, regional, or local public health authorities and offered free of charge within schools. However, the effectiveness of SLV for increasing HPV vaccination rates in the United States is likely to be substantially limited due to a number of identified barriers, the most significant of which is with the need to bill for vaccines among adolescents not covered under the Vaccines for Children Program. HPV vaccination within school-based health centers (SBHCs) has been much more effective than SLV, but SBHCs exist in only 2% of schools in the United States. The opportunity gap between the United States and other countries will remain unless reimbursement issues related to HPV delivery in schools can be addressed in a sustainable manner or SBHCs become much more common.
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Affiliation(s)
- Allison Kempe
- ACCORDS (Adult and Child Consortium for Health Outcomes and Delivery Science), University of Colorado Anschutz Medical Campus, Aurora, Colo; Children's Hospital Colorado, Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colo.
| | - Mandy A Allison
- ACCORDS (Adult and Child Consortium for Health Outcomes and Delivery Science), University of Colorado Anschutz Medical Campus, Aurora, Colo; Children's Hospital Colorado, Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colo
| | - Matthew F Daley
- Institute for Health Research, Kaiser Permanente Colorado, Denver
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Abstract
Previous research has implied that while parents may be willing to have their adolescents receive some recommended vaccines via school-located vaccination program (SLVP), they were less likely to agree to the HPV vaccine being administered via SLVP. During an SLVP in a large urban area, 86% of those participating in the program received an HPV vaccine.
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Affiliation(s)
- Amy B Middleman
- a Department of Pediatrics , University of Oklahoma Health Sciences Center , Oklahoma City , OK , USA
| | - Tiana Won
- b Department of Pediatrics , University of Washington , Seattle , WA , USA
| | - Beth Auslander
- c Department of Pediatrics , University of Texas Medical Branch at Galveston , Galveston , TX , USA
| | - Sanghamitra Misra
- d Department of Pediatrics , Baylor College of Medicine , Houston , TX , USA
| | - Mary Short
- e Department of Psychology , University of Houston-Clear Lake , Clear Lake , TX , USA
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Abstract
Adolescents were first specifically targeted for school-located vaccination (SLV) in the 1990s when hepatitis B catch-up vaccination was recommended for all adolescents. SLV affords the opportunity to access adolescents at a time when their activities have developmental import and the patients have the capacity to decline repeatedly missing school and extracurricular events to get vaccinated. As noted above, SLV has been primarily reserved for brief catch-up interventions among youth, with routine vaccination recommendations quickly defaulting to the primary care provider. Now in 2016, with relatively disappointing adolescent immunization rates for the routinely recommended human papillomavirus (HPV) vaccine, the SLV option is one that could potentially help increase vaccination rates for a particularly effective, life-saving, 3-dose vaccination series. This article will serve as a brief review of the successful use of SLV in other countries, lessons learned when SLV was employed to immunize adolescents against hepatitis B in the United States in the late 1990s and early 2000s, and the current hopes and challenges for the future of adolescent SLV programming in the United States. Overall, the shift to the use of SLV to administer routinely recommend vaccine for adolescents will require careful planning to implement known strategies for accessing youth and in addition to new strategies designed to assure appropriate reimbursement for cost-effect SLV services. While not the best option for all adolescents, SLV provides an important opportunity to immunize youth with limited access to healthcare services in the community at large.
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Affiliation(s)
- Amy Middleman
- a Department of Pediatrics , Section of Adolescent Medicine, University of Oklahoma Health Sciences Center , Oklahoma City , OK , USA
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Abstract
School-located vaccination (SLV) has a long history in the United States and has successfully contributed to lower morbidity and mortality due to vaccine-preventable diseases.(1) Historically, SLV efforts, which tended to be single-vaccine programs intended to provide catch-up immunization to a defined school-age cohort or were implemented in response to an outbreak, were unfunded, funded by local health department, or were funded by industry or federal grants. The growing palette of vaccines recommended for routine use in adolescents along with limited success of office-based adolescent immunization create a compelling argument for the creation of financially sustainable SLV programs. An arguably significant barrier to both office-based and school-located adolescent immunization is the modest reimbursement rates afforded to immunizers. Because the immunization promotion and consent process is expensive, these costs must be reduced to a minimum to reach financial viability. Although there are challenges to creating a financially sustainable SLV program coordinated by an academic medical center, (AMC), the ability of AMCs to bill private and public insurers, the nonprofit status of medical centers, the allowances for faculty for academic pursuit, and the substantial infrastructure already present make AMCs a potentially practical site for the administration of SLV programs. Alternatively, as health departments throughout the nation continue to explore methods for billing private insurance, we may find health departments to be uniquely suited for coordinating the administration and billing of these services.
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Affiliation(s)
- Heather M. Limper
- Department of Pediatrics, University of Chicago Medicine, Chicago, Illinois; and,Department of Pediatrics, University of Illinois at Chicago Medical Center, Chicago, Illinois
| | - Jennifer L. Burns
- Department of Pediatrics, University of Chicago Medicine, Chicago, Illinois; and
| | - LaKesha M. Lloyd
- Department of Pediatrics, University of Chicago Medicine, Chicago, Illinois; and
| | - Jennifer Atilano
- Department of Pediatrics, University of Chicago Medicine, Chicago, Illinois; and
| | - Kenneth A. Alexander
- Department of Pediatrics, University of Chicago Medicine, Chicago, Illinois; and
| | - Rachel N. Caskey
- Department of Pediatrics, University of Illinois at Chicago Medical Center, Chicago, Illinois
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Ha C, Rios LM, Pannaraj PS. Knowledge, attitudes, and practices of school personnel regarding influenza, vaccinations, and school outbreaks. J Sch Health 2013; 83:554-561. [PMID: 23834607 DOI: 10.1111/josh.12065] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 07/03/2012] [Accepted: 08/12/2012] [Indexed: 06/02/2023]
Abstract
BACKGROUND School personnel are important for communicating with parents about school vaccination programs and recognizing influenza outbreaks. This study examined knowledge, attitudes, and practices of school personnel regarding seasonal and 2009 H1N1 influenza, vaccinations, and school outbreak investigations. METHODS Data were analyzed from survey interviews of 58 elementary and middle school personnel in 2010. RESULTS Principals, assistant principals, and nurses have higher knowledge than front office clerks regarding seasonal (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.15-5.42) and 2009 H1N1 influenza (OR: 2.04, 95% CI: 1.19-3.71). During 2009-2010, 63.8 and 19.0% of school personnel received seasonal and 2009 H1N1 influenza vaccine, respectively. Personnel were more likely to be vaccinated against seasonal influenza if they believed the vaccine was safe (OR: 2.26, 95% CI: 1.21-4.19). Of those unvaccinated against 2009 H1N1, 48.9% also cited safety concerns. While every principal, assistant principal, and nurse received both infectious diseases and outbreak trainings, only 42.5 and 27.5% of clerks received these trainings, respectively (p < .001), and 30% of clerks believed outbreak recognition was not their responsibility. CONCLUSION The level of knowledge regarding influenza illness, vaccination, and outbreaks among subjects was low overall. Education of school personnel may improve school vaccination programs and control of influenza outbreaks.
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Affiliation(s)
- Chrysanthy Ha
- Children's Hospital Los Angeles, 4650 Sunset Blvd, MS#51, Los Angeles, CA 90027, USA
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