The Denver In-School Immunization Project: The Perspective of Denver Public School Personnel

Background: During the 2009-2010 school year, Denver Health (DH) provided in-school vaccination to consented elementary school students (influenza vaccine only) and middle school students (influenza and age-appropriate vaccines) attending Denver Public Schools (DPS).

Setting: Twenty elementary and seven middle schools within the DPS system.

Population: Thirty-four in-depth interviews and four focus groups were conducted with DPS personnel. Interviews were conducted with school system administrators, school principals, and school-based paraprofessionals. Focus groups were conducted with school nurses and project-based paraprofessionals.  

Project Description: Interviews and focus groups with principals and nurses indicated strong support for and satisfaction with in-school vaccinations at school and parental levels. However, interviews with system administrators indicated that inter-institutional collaboration between DH and DPS faced a number of interactional difficulties and practical challenges. Interactional difficulties included the legal constraints that affected and shaped project development, the failure to sufficiently forge a cooperative relationship at project onset, and inadequate communication within and across institutions. Practical challenges included difficulty securing adequate supplies to support pre- and post- clinic activities, establishing consistent buy-in from school nurses, identifying ideal sites and times for the clinics, and managing the increased workload of school nurses and DPS administrative personnel.

Results/Lessons Learned: The project resulted in increased expenditure of time and resources at multiple levels of the school system. However, the project was received favorably by parents and school personnel and functioned effectively to minimize disruption of the school day. Lessons learned during the first year of implementation have resulted in changes to the consent process and increased opportunities for parents to learn about the program, which have led to a significant increase in the number of consented students participating in the program.  Collaboration and communication, including clarity of mission and role definition, are crucial for the success of such a project.