School-Located Seasonal and 2009 H1N1 Influenza Vaccine Initiative

Background: In 2008, the Advisory Committee on Immunization Practices recommended that all school aged children should receive seasonal influenza vaccine. Subsequently, the arrival of pandemic 2009 H1N1 influenza added an additional recommended influenza vaccine. In Massachusetts there are approximately 1.4 million school-aged children living in 351 cities and towns, most of whom receive their childhood immunizations within their medical home. It quickly became apparent that the medical home did not have the capacity to vaccinate this large number of children on an annual basis. Additional resources were needed to provide the capacity to vaccinate all Massachusetts school-aged children with influenza vaccine every year.

Objectives: Establish influenza vaccination outside of the medical home in a sustainable model that collaborated with the patient’s medical home.

Methods: Massachusetts Department of Public Health (MDPH), Immunization Program, School Health Unit and Northeastern University School Health Institute collaborated in an effort to promote the school-located seasonal and 2009 H1N1 influenza vaccination. Three regional seasonal and 2009 H1N1 influenza trainings, as well as 30 regional vaccine administration refresher courses were offered to school and public health nurses. State-purchased seasonal influenza vaccine and federally provided 2009 H1N1 vaccine were allocated to the school-located initiatives.

Results: Starting in September 2009, 88 school systems conducted school-located seasonal influenza clinics, administering greater than 57,000 doses of seasonal influenza vaccine. By January 2010, 321 out of 351 cities and towns conducted school-located 2009 H1N1 influenza clinics staffed by a variation of school and public health nurses operating both during and after school hours.

Conclusions: By providing education and training to school and public health nurses we were able establish a viable option outside of the medical home to expand our capacity to vaccinate the school aged children with seasonal and 2009 H1N1 influenza vaccine.