KEYWORDS:
adolescent immunizations
school-based clinics
Hepatitis B
school entry requirements
Managed Care organizations

BACKGROUND:
The Colorado State Board of Health mandated that after July 1, 1997 all students entering the seventh grade would be required to complete a 3-dose series of Hepatitis B vaccine. In September 1996 in Denver a free, voluntary school-based Hepatitis B vaccination program was implemented.

OBJECTIVE(S):
To evaluate the effectiveness of a school-based adolescent vaccination program in assisting students to complete immunizations required for school entry.
To evaluate the effectiveness of financing the program in part through revenue from Managed Care organizations.

METHOD(S):
The Hepatitis B series was administered to students at school during a series of four school-based immunization clinics at each of the 18 Denver Public middle schools for those students whose parents consented. Evaluation consisted of a descriptive analysis including program enrollment, immunization status of students and program costs.

RESULT(S):
The program is in its 6th year and continues to enroll approximately 85% of the district's sixth grade students. With time, an increasing number of parents are declining vaccinations at school. The first year of the program 72% of the students enrolled in the program received vaccines at school and 12% received vaccine through their PCP. These percentages have changed to 51% and 38% respectively for the current school year. Managed Care revenue for the program was difficult to obtain and in the first year of operation only covered 15% of the direct program costs.

CONCLUSIONS(S):
The school-based immunization program is successful in providing vaccines to students for school entry requirements. Financing the program through contracts with Managed Care organizations was unsuccessful.

LEARNING OBJECTIVES:
To describe a school-based adolescent immunization program.
To describe changes in participants in this program over time.
To understand the problems associated with financing the program through Managed Care revenues.