Current Experience with School-Located Influenza Vaccination Programs In the United States: A Review of the Medical Literature

Background: In the United States, annual influenza vaccination is recommended for all children 6 months through 18 years of age. Annual school-located influenza vaccination (SLIV) programs are an efficient means to immunize large numbers of school-age children.

Objectives:  To summarize the collective experience regarding recent US SLIV programs to benefit future programs.

Methods: A review of the medical literature, including recent scientific conference presentations, was conducted to identify reports of US SLIV programs. Publications from January 2000–May 2010 that provided quantitative data from SLIV programs were included.

Results:  Published reports or abstracts for 36 SLIV programs (20 seasonal, 13 H1N1, and 3 both seasonal and H1N1) were identified, some of which spanned multiple years. Many early SLIV programs were formal studies or pilot programs conducted with manufacturer support; however, since 2006, with one exception, programs have taken place without manufacturer assistance. Programs vaccinated from 70 to 128,228 students; where reported (n=24), coverage ranged from 7% to 73%. Evaluating the highest rate achieved in each program, 15 vaccinated 40% or more, 7 vaccinated 20%-39%, and 2 vaccinated less than 20%. Higher coverage was achieved in elementary schools versus middle and high schools. Where reported, classroom disruption was generally described as minimal. Faculty and staff were immunized in some programs; where reported, 5 to 20 teachers were vaccinated for every 100 students vaccinated. Most SLIV programs vaccinated children without charge. Costs, where reported, ranged from approximately $20–$27 per dose delivered, including vaccine and administration costs.

Conclusions:  In the US, successful SLIV programs have been conducted in individual schools, school districts, and statewide, often vaccinating 40%–50% of students. SLIV programs may be less costly than vaccinating children elsewhere. A national, financially sustainable model would support future development of SLIV programs. Sponsored by MedImmune.