Caskey Rachel N, Macario Everly, Johnson Daniel C, Hamlish Tamara, Alexander Kenneth A
Department of Pediatrics, University of Illinois at Chicago;
Department of Pediatrics, University of Chicago
J Pediatric Infect Dis Soc. 2013 Sep;2(3):198-204. doi: 10.1093/jpids/pit001. Epub 2013 Feb 11.
Many adolescents underutilize preventive services and are underimmunized.
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.
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.
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.
许多青少年未充分利用预防服务，且疫苗接种不足。
为促进医疗之家并提高疫苗接种率，我们构思并实施了一项为期3年、涉及8所学校的试点学校疫苗接种合作项目。在实施前一年，我们征求了社区、家长和学校护士的意见。我们选择了以医疗补助参保学生或符合医疗补助条件的学生为主的学校，为其提供儿童疫苗计划库存疫苗。由一名大规模免疫接种工作人员雇佣的护士每年在参与项目的学校接种3次这些疫苗。
在3年时间里，我们在学校接种了约1800剂疫苗。学校管理人员、健康中心和附近的私人医生普遍欢迎该项目。家长未明确表达对学校疫苗接种的担忧。由于学校任务繁重，学校护士无法参与。通过背包邮件获取家长同意是一个低效的过程，课堂激励措施并未提高同意书返还率。流感疫苗接种率最高。接种疫苗的最佳时间是在正常上课时间。
尽管为青少年在学校接种疫苗是可行的，但这对社区成员来说是一种模式转变，因此在实施过程中会面临挑战。校长或学校工作人员更替率高导致机构记忆缺失。直接与家长沟通很困难。由于我们不确定收到同意书的家长比例，我们正在探索基于互联网和返校注册的选项，以使同意书分发和返还过程更加严格。在每所学校确定一名疫苗接种倡导者有助于疫苗接种工作。确定一个经济上可持续的学校疫苗接种模式对于在全国范围内推广学校疫苗接种至关重要。
