Acceptability of School Located Intranasal H1N1 Influenza Vaccination Program, Philadelphia, PA

Background: The Philadelphia Department of Public Health (PDPH) provided 32,971 intranasal vaccinations for the city’s public school students as part of the 2009 H1N1 school located vaccination (SLV) program.  

Objectives: To assess school nurse perceptions of intranasal live influenza vaccination provided through SLV.  

Methods: School district nurses who participated in the H1N1 SLV program were surveyed via SurveyMonkey in April, 2010, eight weeks after the program ended, regarding their involvement and perception of the success of each aspect of SLV, including parental understanding and consent, student reaction and tolerance, and school support.  

Results: Of the 143 school nurses who responded to the survey, 68% believed that a live virus vaccine was safe to use in SLV, and 90% did not feel that offering an injectable vaccine would have improved the program. Most nurses (93%) found that students easily tolerated intranasal vaccine. Twenty-seven percent of nurses reported that there was insufficient time to review vaccination consent forms (VCFs) and 42% found VCFs to be inconsistent with the school’s health records for students. Only 50% thought that the VCF was clear and understandable for parents and 41% reported that parents had difficulty completing the form. Many nurses reported that parents had questions about the program (59%), concerns over the safety of the vaccine (67%), and did not have materials in other languages readily available to them (27%). Overall, 59% of nurses reported that parents were supportive of the program.

Conclusions: Although many school nurses found administration of intranasal live influenza vaccine to be acceptable, some were skeptical of its safety. In addition, there were significant difficulties completing and reviewing the VCF. Advanced training and education for school nurses and parents might improve future SLV efforts.