Monroe County School Kids Influenza Prevention Project (MCSKIPP): Obtaining Parental Consent

Background: School-based seasonal influenza vaccination (SSIV) is being considered, but little is known about the coordination required for real-world SSIV in partnership with mass immunization providers.

Objectives: Monroe County School Kids Influenza Prevention Project (MCSKIPP) is evaluating the feasibility, acceptability, and effectiveness of SSIV in urban and suburban elementary schools. We assessed rates of parental consent for vaccination and completion rates of forms during Year 1.

Methods: NY State DOH allowed the MCSKIPP mass vaccinator to provide VFC vaccine and bill an administration fee, and most local insurers accepted billing from the mass vaccinator. Interested school districts agreed to influenza vaccination during school hours. Enrolled schools were randomly assigned to be a Low Intensity School (LISs mailed reminders and blank consents to parents in September) or High Intensity School (HIS=Low Intensity intervention plus more frequent reminders + additional blank consent in October + 2 autodialer reminders prior to flu clinic).

Results: Twelve urban schools (2720 children in HIS, 2411 LIS) and 9 suburban schools (2507 children in HIS, 1829 LIS) participated. In HISs, 19% of students (20% suburban, 19% urban) returned consents; in LISs, 15% (15% suburban, 15% urban) returned consents. Many consents required contact with families for completion. In HISs 16% of consents were incomplete (10% suburban, 23% urban); in LISs, 24% of consents were incomplete (9% suburban, 36% urban).

Conclusions: School districts have unique personnel and cultures; recruitment and implementation must be personalized. In Year 1, almost 20% of elementary students returned consent for school vaccination, thus SSIV may have lessened the burden of vaccination on primary care offices. School autodialers, used at no additional cost (only in High Intensity schools), may have boosted parental response. Efforts to enhance completion of consents, particularly in urban schools, are needed to maximize efficiency of SSIV.