KEYWORD1:
School Immunizations, Infant Immunizations, Barriers

BACKGROUND:
Maricopa County Department of Public Health (MCDPH)identified a correlation between the implementation of the Hepatitis B school requirement and the decline of infant visits to immunization clinics. In 1996 40% of the children seen at public health immunization clinics were infants. Since 1997, the year the requirement was implemented, the percentage dropped to 20%. Problems were identified at an immunization clinic co-located at the largest WIC site. WIC infants were not attending the clinic due to the large volume of school children. This resulted in long lines. MCDPH has seen a sinificant decrease in the National Immunization Survey Rates for Maricopa County. Currently the county and the state of Arizona are 48th in the nation for children completed by two.

OBJECTIVE:
Increase the immunization rates of infants while assuring that school age children receive the required immunizations.

METHOD:
In July 2002, MCDPH established a Back-To-School Clinic. This centrally located clinic offers evening hours five days a week. All schools were notified and Community Information and Referral was enlisted to help direct school children to this location. MCDPH simultaneously increased the number of WIC only immunization sites from two to five. This would decrease the number of school children seen at other immunization clinics, making it more assessable for infants.

RESULT:
The Back-To-School Clinic was overwhelmingly accepted by schools and parents. During the first three months, 93% were school age and 7% were under 2.

CONCLUSION:
Full-time school clinic will be maintained year round. An additional school focused clinic will begin in early 2003. WIC immunization sites will incrementally increase throughout 2003. School children and infants require different service delivery models that can be accommmodated in existing programs.
LEARNINGOBJECTIVES:
Identify methods and procedures for designing and implementing clinics for different populations.