Transcript Implementing Expanding Influenza Vaccine Recommendations Schools Issue Consent forms Forms difficult to understand Language barriers with parents Forms sent home to students but never reach parents Schools need.

Implementing Expanding Influenza Vaccine
Recommendations
Schools
Issue
Consent forms
Forms difficult to understand
Language barriers with parents
Forms sent home to students but never reach
parents
Schools need consent forms approved by legal
consultant, often takes a long time - becomes a
disincentive for schools to buy into holding
clinics
Parents do not understand the importance of
annual seasonal flu vaccination
Approach
Develop standardized consent form nationally
approved by legal/school/public health
associations to accelerate legal approval process
o Immunization Action Coalition has
model physician order forms; MedImmune
has template consent forms
Require all students return consent forms
regardless of accepting or declining vaccination
Provide incentives
o MedImmune noted how offering
children small prizes largely improved
response rate among younger children in
returning consent forms
Improving social marketing/communication
message on benefits of flu vaccination (e.g.
parents miss fewer days of work to care for ill
children, school sports coaches encouraging
students to be vaccinated so that they miss fewer
days in the season)
oNeed CDC/HHS to help identify effective
messages
Communicating to parents the
importance of annual flu vaccination
Use existing tools/campaigns to deliver
message
o“Say Boo to the Flu”
o“Don’t Get Sidelined by the Flu”
o“Spread the Word, Not the Flu”
oNational Influenza Vaccination Week
Organize national focus groups to develop
unified messages (e.g. Gardasil “One Less”
campaign and “I Choose” commercial)
Partner with local organizations and others (e.g.
employers of parents) to develop messages
appropriately target community being served
Use multiple avenues of communication –
email, reverse 911 communication system
(Knox Co.), PIO
oDifferences among communities will
require a menu of messages and
approaches – necessary to make wide
variety of messaging resources available to
health depts, schools, and parents
Funding
Paying for vaccine (challenges specific to
universal and non-universal states)
Covering administrative fees
Billing for Medicaid
Timing of funding – late notice does not
allow enough time to plan clinics
Sustainability
 Additional challenges with annually
vaccinating children; sustaining
interest/awareness
Competition with other public health interests
within schools and health depts (asthma, obesity,
physical inactivity)
Have insurance companies invest $ in the
state and have state purchase school clinic
flu vaccines (option currently discussed in
Vermont)
RFA to identify ways to partner with 3rdparty billing
Advocate for flexibility in federal/state
grant funding
RFA for LHDs/schools to build infrastructure
to conduct annual clinics
Very important to consider annual occurrence
of flu vaccination when building infrastructure
Infrastructure would include ability to provide
shots and ensure staffing
Some approaches have been to follow public
health preparedness infrastructure and
integration with those services
Logistics
Finding appropriate school space
Receiving vaccine in time for clinics
Scheduling
Staffing (1 nurse serves multiple schools)
Coordinate with schools in advance so space
can be reserved and clinics do not overlap with
field trips, school exams, etc…
oCould allow teachers to coordinate flufocused lessons
Team up nurses serving multiple schools
“Clinic in a Bag” – Anne Arundel County
Utilize HD sanitarians, parent volunteers, high
school students to carry out logistics of clinic
set-up
o Especially beneficial for high school
students needing to earn volunteer/service
hours
o Could use residents, nursing school
students, MRCs for one-time clinics but
liability, supervision, and training are
issues
School buy-in/Competing priorities
Some school health programs are under DOE
School nursing is sometimes housed in public
health and sometimes in the school district
Make immunization compliance a performance
measure
Garner administrative support from school
district and individual schools (e.g.
superintendents, school board representatives,
and principles)
Partner with National Education Association
(NEA), National Association of State Boards of
Education (NASBE), National Association of
School Nurses (NASN), and other professional
associations to deliver effective messages to
school districts and schools
Increased collaboration between CDC/HHS
and Department of Education (DOE) to develop
coordinated support and resources
Advocate for standardized method to provide
or oversee school health services
oBarriers arise w/ larger school districts
(e.g. Seattle/King County)
Letter from superintendent/principal
recommending vaccination.
Assessment/Evaluation
No comprehensive sense of:
oCurrent school practices
oWhat is the actual coverage of students in
schools (tracking who is not immunized,
who is immunized in schools, or who is
immunized in another healthcare setting)
oWhat is the public health impact of the
school-based clinics
Universal states have not observed higher
immunization coverage – why?
Establish central system for collecting best
practices
Promote use of registries
Shot cards (though may not be appropriate for
all)
Advocate for:
oIntegration of immunization registries
with student databases
IT capacity among HDs and schools
is major barrier
oMore systematic collection of student
data and immunization information
Would require major software
overhaul and pose challenges when
system/software updates occur
oImproved data collection