School-Located Vaccination of Adolescents: A Survey of Parent Attitudes

Background: Although school-located vaccination programs may need to bill health insurance for vaccines given, parent attitudes about such programs are not well known.

Objectives: The objectives of this study were to assess, among parents of adolescent students: 1) attitudes about school-located vaccination; 2) attitudes about billing for vaccines received at school; and 3) factors associated with strongly supporting school-located immunization.

Methods: From January through May 2010, 7 public schools in Denver, CO participated in a voluntary school-located immunization program that billed health insurance for vaccines given. In April through June 2010, a survey was administered in English and Spanish to parents of 1000 randomly selected 6th through 8th grade students at these schools.

Results: Survey response rate was 66%. Fifty-six percent of parents strongly supported school-located vaccination; an additional 29% were somewhat supportive. Thirty-eight percent strongly agreed and 44% somewhat agreed that it was "better to get vaccines at the doctor's office than school" because other health needs could be addressed at the same time. However, 41% strongly agreed and 36% somewhat agreed that vaccination at school was more convenient than vaccination at the doctor's office. Twenty-five percent did not want to give out health insurance information in order for their child to receive vaccines at school. In multivariate analyses, parents who viewed school-located vaccination as convenient were more likely to support it (risk ratio [RR] 1.63, 95% confidence interval [CI] 1.31 to 2.15). Parents who reported concern about keeping track of vaccines given at school (RR 0.84, 95% CI 0.74 to 0.95) were less likely to support school-located vaccination.

Conclusions: While most parents preferred vaccination in their child's medical home, most also appreciated the convenience of school-located vaccination. One-quarter did not want to provide health insurance information to a school-located program, which may restrict participation for some students.